Coordinator III - Care Management Associate

Job Summary:

• Supports clinical nurses whether in the office or out in the field.
• Interact with external providers and deliver excellent customer service.
• Promotes and supports quality administration of healthcare services.
• Process intake of services via electronic fax system.
• Research member eligibility information before creating any authorizations.
• Creates authorizations in our database and faxes back authorization numbers to the providers.
• Coordinates all types of admissions for appropriate discharge dates with the hospitals.
• Requests medical records for all admissions for clinical nurses if needed.
• Protects the confidentiality of member information and adheres to company policies.
• Must possess strong customer service skills to coordinate services.
• Computer literacy is a must to be able to navigate through internal and external systems.
• Familiar with basic medical terminology and concepts of care management.
• Effective communication, telephonic and organizational skills.
• Proficient in keyboarding, typing 45 wpm with min score of 6500 alphanumeric skill set.

Duties:

• Process intake of services via electronic fax system.
• Research member eligibility information before creating any authorizations.
• Creates authorizations in our database and faxes back authorization numbers to the providers.
• Coordinates all types of admissions for appropriate discharge dates with the hospitals.
• Requests medical records for all admissions for clinical nurses if needed.
• Protects the confidentiality of member information and adheres to company policies.
• Must possess strong customer service skills to coordinate services.
• Computer literacy is a must to be able to navigate through internal and external systems.
• Familiar with basic medical terminology and concepts of care management.
• Effective communication, telephonic and organizational skills.
• Proficient in keyboarding, typing 45 wpm with min score of 6500 alphanumeric skill set.

Education:

• High school diploma or GED required.

Experience:

• 1 - 2 years’ experience as a medical assistant, office assistant.
• Strong customer service skills.
• Strong problem-solving and analytical skills.
• Possess strong computer navigation skills.
• Comfortable with regular feedback and development.
• Works well in a team environment.
• Must have basic medical terminology experience.

SafetySensitive Role:

Internet Requirement:

• Must be able to hardwire into home internet.
• Must submit a screenshot of upload/download speed with resume.

Top 3 Required Skills:

Customer Service & Provider Coordination:

• Ability to interact professionally with external providers, support clinical nurses, coordinate admissions, request medical records, and maintain confidentiality.

Computer Navigation & Systems Accuracy:

• Proficiency in navigating multiple computer systems, processing electronic faxes, researching eligibility, creating authorizations, and ensuring accurate data entry.

Medical Terminology & Healthcare Workflow Knowledge:

• Basic understanding of medical terminology, admissions processes, authorization workflows, service intake, and coordination of care.

Onsite Requirement:

• Must be local to Client.
• Onsite 1st day.
• Mandatory weekend training: One Saturday in April and one Saturday in May (exact dates TBD).
• This position is primarily remote, with occasional onsite requirements based on business needs.