Clinical Support Specialist
10 hours ago
We are seeking a highly skilled Clinical Assistant to join our team at Global Channel Management. As a Clinical Assistant, you will play a critical role in supporting our clinical team and providing proactive resources to members related to disease prevention and benefit education.
Key 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, encouraging and motivating them to become compliant.
- Manage system work queues, screening 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.
- Ability to work independently with minimal supervision or function in a team environment.
- 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.
- Ability to work in an independent and creative manner.
Preferred Qualifications:
- Self-motivated and able to manage multiple tasks and set priorities.
- Effective time management skills.
- Excellent oral and written communication skills.
- Strong interpersonal and organizational skills.
- Knowledge in medical terminology.
What We Offer:
- A dynamic and supportive work environment.
- Opportunities for professional growth and development.
- A competitive compensation package.
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