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Clinical Administrative Coordinator
1 month ago
Job Summary: We are seeking a skilled Clinical Administrative Coordinator to support our Utilization Management clinical teams.
Key Responsibilities:
* Assist with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination, and quality of care.
* Provide general support and coordination services for the department, including answering and responding to telephone calls, taking messages, and researching information.
* Assist with reporting, data tracking, gathering, organization, and dissemination of information.
Requirements:
* High School Diploma
* 3 years experience in healthcare claims/service areas or office support
* Medical background, computer skills, medical terminology, claims and service office support, CPT and ICD-10 coding
Preferred Qualifications:
* Two years' experience in healthcare/managed care setting or previous work experience
* Knowledge of CPT and ICD-10 coding
Knowledge, Skills and Abilities (KSAs):
* Ability to effectively participate in a multi-disciplinary team
* Excellent communication, organizational, and customer service skills
* Knowledge of basic medical terminology and concepts used in managed care
* Knowledge of standardized processes and procedures for evaluating medical support operations business practices
* Excellent independent judgment and decision-making skills
* Ability to pay attention to the minute details of a project or task
Essential Functions:
* 35% Performs member or provider related administrative support
* 35% Reviews authorization requests for initial determination and/or triages for clinical review and resolution
* 20% Provides general support and coordination services for the department
* 10% Assists with reporting, data tracking, gathering, organization, and dissemination of information
About Us:
KMM Technologies, Inc. is a certified company with CMMI Level 2, ISO 9001, ISO 20000, and ISO 27000 certifications. We are a WOSB, SBA 8(A), MDOT MBE, and NMSDC MBE certified company.
