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Clinical Support Associate
3 months ago
Job Location
Main Office - Santa Barbara, CA
Position Type
Full Time
Education Level
Associate's Degree
Travel Percentage
None
Job Category
Medical Management
Description
California Hourly Range: $22.56 - $31.58 per hour
Job Summary
A Clinical Support Associate Community Supports (CSA-CS) is assigned to the Community Supports Program. The CSA-CS reports to the Community Supports Program Manager or their designee. The CSA-CS is responsible for providing coordination support for the clinical teams, supporting the daily operational functions, facilitating timely work processes, and performing clerical activities of the Community Supports Program. The CSA-CS must have strong and clear written and verbal communication skills. The CSA-CS is responsible for accurate and timely data entry and data collection. The CSA-CS interacts with other CenCal Health employees, providers, and members. CSA-CS may be responsible for processing authorization and referral requests, completing health surveys with members, and following selected members who need periodic telephonic outreach calls.
Duties and Responsibilities
- Timely answering of inbound calls in the Health Services' phone queues
- Make outbound calls to providers, members, and CenCal Health staff regarding operational processes
- Timely communication of conflicts or difficulties with members or providers to the immediate supervisor
- Maintain confidentiality and privacy of member information in adherence to HIPAA and Confidentiality laws and regulations
- Adhere to CenCal Health's mission, protocols, policies, and procedures and meet required performance standards
- Timely attendance of Company-wide and department meetings and trainings and, as appropriate, actively participate
- Respond to emails, telephone calls, and other modes of communication promptly, professionally, and courteously
- Interact with CenCal Health employees, members, and providers professionally
- Responsible for supporting the daily operational functions, facilitating timely work processes, and performing clerical activities associated with Community Supports
- Work closely with Case Management, the Community Supports team, and internal CenCal Departments related to Community Supports activities
- Managing the call queue, including supporting members, Community Support providers, and providers related to Community Support referrals and provider reassignment process.
- Responsible for the Community Support referral intake process.
- Conduct follow-up calls to members and providers to ensure timely access to Community Support services.
- Organize, schedule, track, and monitor member contacts
- Assist with mailings associated with Community Support (Member assignment and Auth approval notifications)
- Assist with mailings of Community Support NOA's as requested
- Assist the Community Support Program Manager with data tracking as requested
- Other duties as assigned
Knowledge/Skills/Abilities
Required:
- Ability to work independently and follow directions with minimal supervision and as an active participant of an interdisciplinary team
- Ability to utilize constructive feedback as a learning and growth opportunity
- Demonstrate excellent organizational and multi-tasking skills
- Understand basic medical terminology, billing (CPT), and diagnoses (ICD-10) coding
- Maintain member confidentiality and HIPAA compliance
- Must be detail-oriented and maintain clear and accurate records
- Complete assigned duties while adhering to regulatory timelines
- Must be able to type at a minimum of 35 wpm
- Work effectively with people with varying backgrounds and educational levels
- Prepare grammatically correct, clear, and concise correspondence
- Basic knowledge of Medi-Cal and its covered services
- Knowledge of health-related community-based organizations, health care delivery systems, and resources for the low-income and elderly population
- As designated, bilingual in Spanish
Required:
- High school diploma or GED
- Twelve (12) months of full-time, or its equivalent, experience in a medical office, health plan, managed care organization, hospital (ED or inpatient), skilled nursing facility, clinic, or other healthcare setting working directly with patients, members, providers and/or other clinicians
- Successful completion of one of the following accredited education programs: Medical Assistant or Medical Office Professional. Successful completion can substitute for six (6) months of work experience
- Associate degree in business, health science, healthcare, health management, or related field OR three (3) years of experience as a Certified Medical Assistant, Certified Nursing Assistant, or Licensed Vocational/Practical Nurse may substitute for an Associate Degree
- Two (2) years of full-time, or its equivalent, of clinical experience in an outpatient or ED clinic, health plan, managed care, or medical office setting.