Web Inquiry Support Coordinator

3 days ago

Los Angeles, California, United States MedPOINT Management Full time
Job Summary

We are seeking a highly skilled and detail-oriented Web Inquiry Support Coordinator to join our team at MedPOINT Management. As a key member of our team, you will play a critical role in providing exceptional customer service and ensuring timely communication between MSO, IPA providers, and health plan representatives.

Key Responsibilities:

  • Process and respond to web inquiries in a timely and efficient manner
  • Provide accurate and clear written communication to members and providers
  • Identify and address educational needs of providers regarding state, federal, and plan requirements
  • Forward referral requests to clinicians for review and approval
  • Ensure timely response to web inquiry submissions and meet departmental turnaround times
  • Process modification requests in accordance with coordinator hierarchy grid
  • Collaborate with internal and external sources to provide effective departmental communication
  • Verify member benefits and eligibility upon receipt of web inquiry request
  • Utilize authorization matrix, ancillary rosters, and delegation agreements to ensure accurate processing
  • Coordinate with referral clinicians and medical directors to ensure timely processing
  • Maintain knowledge of CMS and Medi-Cal policy guidelines
  • Identify and inform case management clinicians of complex care diagnoses
  • Screen cases for possible California Children Services (CCS) eligible conditions
  • Collaborate with other departments to resolve member/provider matters as needed

Requirements:

  • High school graduate or equivalent
  • One year of medical office experience
  • Knowledge of medical terminology
  • Proficiency in Microsoft Office programs, especially Word and Excel
  • Proficiency in EZCAP a plus

Skills and Abilities:

  • Ability to multitask and adapt to a fast-paced environment
  • Reliable, dependable, and accountable
  • Strong customer service skills with good telephone rapport
  • Ability to empathize with complex cases
  • Self-motivation and ability to work effectively in an independent environment
  • Great critical thinking and problem-solving skills

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