Clinical Services Coordinator, Intermediate

2 months ago


California, United States Blue Shield of California Full time

About the Role

The Blue Shield of California team is seeking a skilled Clinical Services Coordinator Intermediate to join our Children's Health Program (CHP) team. In this role, you will work closely with clinical staff to support member needs, utilizing established and approved medical policies and guidelines that align with nationally recognized standards.

Key Responsibilities

  • Process and manage authorizations, UM/CM requests, and other related tasks
  • Provide administrative support to Case Managers, including mailings, surveys, and data entry
  • Assist with research and eligibility/benefits verification for members and providers
  • Support operational activities to ensure healthcare services are provided to members, employers, and providers
  • Serve as the initial point of contact for members and providers via phone or correspondence
  • Review and process service authorization referrals, system letters, and requests for information
  • Provide clerical support to medical management teams

Requirements and Qualifications

  • Strong communication and organizational skills
  • Ability to work in a fast-paced environment with multiple priorities
  • Proficiency in data entry and management systems
  • Knowledge of medical policies and guidelines


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