Clinical Assistant Professional
4 weeks ago
Clinical Assistant
About the Role
As a Clinical Assistant at Global Channel Management, you will play a vital role in supporting our clinical team and serving as a proactive resource for members related to disease prevention and benefit education.
Responsibilities
* Conduct educational telephone calls advising members of available benefits, services, and programs; complete health needs assessments, and refer members to population health management programs as appropriate.
* Reach out to members with identified gaps in care; encourage and motivate them to become compliant; offer assistance in locating providers and appointment scheduling.
* Manage system work queues; screen identified members for eligibility, prior case activities, recent claims, customer service inquiries, and authorization history; assign members to clinical teams for call outreach and intervention.
* Facilitate research and analysis of inquiries and/or complaints related to processes and designations, member lost incentives, and other program-related inquiries.
Requirements
* 1 year of experience in a customer service support role is required.
* Possible COVID-19 vaccine mandate.
* Proficient interpersonal and organizational skills.
* Independent, sound decision-making and problem-solving skills.
* Healthcare environment knowledge, including provider reimbursement methodologies, ICD-9-CM, CPT, HCPCS, and UB-92 coding, UHDDS coding guidelines, and AHA Coding Clinic.
* Ability to work independently with minimal supervision or function in a team environment, sharing responsibility, roles, and accountability.
* Excellent oral and written communication skills.
* Strong interpersonal and organizational skills.
* Knowledge in medical terminology.
* Various immunizations and/or associated medical tests may be required.
Work Environment
* Work overtime as needed.
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