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Clinical Operations Coordinator
Summary / Objective:
The Clinical Operations Coordinator provides administrative support to the Clinical Operations Department. The position supports a variety of departmental activities, requiring excellent time management, problem solving abilities, and professional integrity. In a fast-paced environment, the position requires strong communication skills, ability to multitasks and attention to detail.
Essential Functions:
- Field customer and provider phone calls, voicemail, fax, and email related to authorizations or care management.
- Answers the phone and transfers calls to the appropriate staff member or department. Limiting the number of calls on hold. Ability to answer questions within scope of position.
- Responsible for processing inbound and outgoing mail. Includes cataloging/logging requests for audits, creating mailing labels, updating addresses related to returned mail, and documenting in client record of completed communications.
- Label and sort incoming electronic requests and redirect to appropriate staff or department as necessary.
- Data entry which may include authorizations, referrals, or ordering.
- Document written information in appropriate system.
- Reviewing incoming requests for complete information for data entry, and coordinating with requester for additional information when applicable.
- Makes outbound calls, emails or faxes as directed. This may include notifications of approvals and denials to providers and members, routine notifications of completed services, etc.
- Takes mail to the post office in a secure manner to protect PHI during transport.
- Ensures staff compliance with PSW policies and procedures with special emphasis on HIPAA requirements.
- Stays informed of healthcare delivery models, industry trends, services delivered by team, and actively participates in training provided by the company.
Knowledge/Skills/Abilities:
- Excellent attention to detail a must.
- Working knowledge of the healthcare system, including clinical environments, referral processes, insurance coordination, and prior authorization workflows
- Flexible and willing to work in a dynamic and evolving role according to individual patient and program demands.
- Sets a positive example by displaying a pleasant and approachable demeanor and remaining friendly and courteous.
- Proactive team player, strong follow through, quick decision-making abilities and ability to problem solve.
- Interpersonal skills, with the ability to build strong relationships at all levels.
- Strong verbal and written communication skills with customers, supervisors, and co-workers.
- Strong organizational, time management and prioritization skills.
- Self-starter. Ability to set priorities and keep to projected schedules.
- Excellent computer proficiency (MS Office – Word, Excel, and Outlook) including being able to effectively maintain written and computer records in accordance with regulatory agencies.
- Is aware of and supports strategic plans that ensure department and/or company objectives and goals are obtained.
- Implement new policies, procedures and company initiatives as assigned and ensures all areas are maintained in accordance with company policy, state, federal and plan regulatory mandates.
Required Education and/or Work Experience:
- High School diploma or GED
- One (1) year or more in data entry or related experience.
- Excellent history of attendance and on-time performance.
- Experience using MS Office – Excel
- Experience in a healthcare environment, including clinics, referral coordination, prior authorizations, or similar medical administrative functions
Preferred Education and/or Work Experience:
- Knowledge or experience of Medicare payment rules and fee schedules.
Required Certificates, Licenses and Registrations:
- Valid driver’s license and insurance in state of residence and ability to travel as required to perform duties.
*PSW does not typically hire at the top of the pay range *
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Flexible Spending Account (FSA)
- Health Savings Account (HSA)
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
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