Clinical Support Coordinator

Overview:

How We Show Up for Our Patients:
As a leading provider of outcomes-driven care for individuals and communities living with chronic conditions, Somatus is helping patients across the country enjoy More Healthy Days at Home™.

How We’ll Support You:
We offer 25+ health, growth, and wealth work perks to help teammates be the best version of themselves, including:

• Subsidized personal healthcare coverage: Medical, Dental & Vision, plus Wellness programs
• Paid Time Off: Accrual of 3 weeks’ Vacation (PTO)
• Professional development: CEU and tuition reimbursement

Responsibilities:

How You’ll Make an Impact:

Responsible for initial triage of referrals, working with hospitals, facilities, engagement specialists, and the clinical team. Includes managing outbound calls, providing information on available network services, and preparing cases and transferring them to the appropriate clinical staff. Manages the referrals process, processes incoming and outgoing referrals, verification of facility telephone numbers, fax numbers, and if a member is being seen at a specific facility or by the specific doctor.

• Serve as primary support for clinical case managers.
• Extract and manage fax requests for medical or clinical service Outbound calls to providers to request clinical documentation, verify member information, request missing clinical documentation.
• Request clinical information via fax/email containing lab information and/or results.
• Access electronic member files using policy or id number.
• Determine member eligibility.
• Follow protocols to task requests appropriately.
• Reference automated job aid tools via the computer to identify appropriate procedures when needed.
• Review and interpret case history documentation.
• Navigate between computer screens and platforms to research information.
• Reference automated job aid tools via computer to research relevant rules, regulations, or procedures.
• Learn computer system and process changes and updates and incorporate into daily work.
• Contact internal resources if necessary to clarify information.
• Identify appropriate resource (e.g., doctor, resource, contracted provider) to respond to medical requests.
• Communicate with clinical team to ensure provider receives a response when necessary.
• Enter medical request data into relevant computer system.
• Follow standard procedures to complete requests.

This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee. Duties, responsibilities, and activities may change at any time with or without notice. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Qualifications:

How You’ll Strengthen Our Team:

Qualifications:

• High School diploma or GED required.
• At least one year of medical records experience working in a healthcare setting.
• Basic computer skills (able to scan, organize and access electronic health records)
• Strong data entry skills with keen attention to details to ensure accuracy.
• Advanced organization skills
• Excellent time management skills
• Experience using Microsoft Office suite.

Other Duties : Our Commitment to Diversity: At Somatus, we celebrate what makes us unique — our people. We believe that a culture intentionally built to foster and support our unique passions, experiences, and perspectives helps fuel us in the pursuit of our mission. Somatus, Inc. provides equal employment opportunity to all individuals regardless of race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by law. Discrimination of any type will not be tolerated.