Clinical Coordination Specialist
2 weeks ago
**Job Overview**
Elevance Health is a leading health company dedicated to improving lives and communities. We are seeking an experienced Clinical Coordination Specialist to join our team.
**Estimated Salary:** $45,000 - $60,000 per year, depending on experience and qualifications.
Responsibilities:
- Coordinate cases for precertification and prior authorization review.
- Determine contract and benefit eligibility; provide authorization for inpatient admission, outpatient precertification, prior authorization, and post-service requests.
- Refer cases requiring clinical review to a Nurse reviewer.
- Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate.
- Respond to telephone and written inquiries from clients, providers, and in-house departments.
- Conduct clinical screening process.
- Authorize initial set of sessions to provider.
- Checks benefits for facility-based treatment.
Requirements:
- High School diploma or GED.
- Minimum of 1 year of customer service or call-center experience; or any combination of education and experience which would provide an equivalent background.
- Preferred skills: medical terminology training and experience in medical or insurance field, FHPS experience.
About Elevance Health
We are a Fortune 25 company with a longstanding history in the healthcare industry. Our values and behaviors are designed to advance our strategy, power our business outcomes, and drive shared success for our consumers, associates, communities, and business.
Benefits
- Market-competitive total rewards including merit increases, paid holidays, Paid Time Off, and incentive bonus programs.
- Medical, dental, vision, short and long-term disability benefits.
- 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources.
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