Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. Accurately registers patients and performs laboratory order entry in the hospital EMR. Obtains venous blood samples via venipuncture/skin puncture and collects non-blood samples from patients of all ages using proper technique. EEO/AA/Disability/Veteran Responsibilities - 1. Conducts interviews with patients in person. Enters accurate and complete demographic and insurance information for visit. - 2. Correctly identifies and wristbands laboratory patients - 3. Administers and obtains signatures on all necessary regulatory forms (e.g. HIPAA disclosure, Patient Financial Authorization, Medicare Secondary Payer questionnaire information). - 4. Accurately transcribes laboratory orders from paper requisitions including ordering provider, entering ICD (X) codes, copy to provider and fax/phone requests. - 5. Performs Medical Necessity Screening and issues Advance Beneficiary Notices to patients when appropriate. - 6. Scans patient identification, insurance cards and laboratory requisitions in a timely manner to ensure information is available electronically. - 7. Follows downtime procedures as required - 8. Collects a high volume of blood specimens (skin puncture and venipuncture), nasal and throat swabs and other non-blood specimens using appropriate technique while maintaining the integrity of the specimen in relation to the test to be performed. - 9. Utilizes systems for identification, collection, transport and disposal of specimens, adhering to internal and external policies and regulations. - 10. Ensures all required elements are included on laboratory requisitions for compliance. - 11. Verifies accuracy of all paper and/or electronic orders prior to collection of specimens. - 12. Organizes and prioritizes work to provide optimal patient care while adhering to established guidelines for specimen procurement, safety and correct identification. - 13. Recognizes and evaluates the presence of complications in collecting blood and selects appropriate solutions for them (e.g. patients on anticoagulants, radical mastectomy, syncope, difficult veins, IV?s). - 14. Performs all duties precisely and efficiently under continually changing conditions. - 15. Instructs patients on preparation for special tests and/or provides specimen collection instructions as appropriate. - 16. Responsible for proper care and use of hospital equipment (e.g. hand-held collection devices, computers, printers, etc.). - 17. Adheres to all safety procedures in the handling of hazardous materials and blood borne pathogens. - 18. Follows all procedures on safe patient interactions and body mechanics. - 19. Maintains clean, well-stocked work areas. - 20. Meets performance expectations for Customer Service, Teamwork, Resource Utilization, and Staff and Self Development as outlined in performance review. - 21. Performs other duties as assigned or directed to ensure smooth operation of the department/unit. Qualifications EDUCATION High School diploma required. Formal education and/or clinical training from an approved phlebotomy program preferred. EXPERIENCE Previous phlebotomy experience and/or phlebotomy certification required. Good keyboarding skills, computer experience and excellent customer service required. LICENSURE Valid driver's license required. ASCP certification preferred. SPECIAL SKILLS Department training for EMR use, registration and order entry functions along with one-on-one phlebotomy training. YNHHS Requisition ID 176494

Position Description Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more. At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.” Provides administrative support to assigned clinical team, as directed by the Team Lead and/or Manager. The Clinical Support Specialist will perform administrative tasks that support clinical processes (e.g. UM, CM, PHM), including but not limited to building medical management records (e.g. authorizations and referral management), compliance report monitoring, and completion of member/provider communications Responsibilities and Qualifications - Assists with medical record documentation requests and leverages medical management system to initiate case and/or authorization to support clinical processes (e.g. UM, CM). - Conducts fax and telephonic outreach; and written communications to members and/or providers to communicate status of UM/CM processes (e.g. verbal notification, engagement status, discharge plan). - Supports administrative functions with community events (e.g. health fairs) - Accurately documents all interventions in the member’s medical management record in accordance with established policies and procedures. - Actively participates in supporting department compliance and performance through administrative activities such as report monitoring/distribution, and other tasks as assigned by leadership. - Adheres to all regulatory and compliance standards, including adherence to all Capital and department specific policies and procedures. - Interacts courteously and professionally with customers, including internal staff, vendor partners, providers, and members to support collaborative medical management functions. - Identifies and reports potential quality of service/care issues as established and within the guidelines of intradepartmental processes. - Promotes personal growth through participation in staff meetings, appropriate in-services, and corporate training. - Identifies opportunities and proposes alternatives for improving the Population Management functions. Skills: - Strong organizational and time management skills. - Demonstrated strong attention to detail and accuracy. - Ability to follow job responsibilities as outlined in departmental policies and procedures. - Excellent written and oral communication skills. Knowledge: - Working knowledge and operation of a personal computer, including proficiency in Microsoft Office applications. - Working knowledge of medical terminology. - Working knowledge of the health insurance industry, health plan benefits and product lines (e.g., PPO, POS, HMO, FEP, Senior Products, Traditional/Comprehensive). - Knowledge of regulatory and accreditation standards and requirements (e.g. NCQA, CMS). Experience: - Minimum 2 years’ experience in the medical field (e.g. medical assistant, medical secretary) or 2 years’ experience in a managed care clinical department. Education and Certifications: - High School Diploma required. - Continued higher education preferred. About Us We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.

• Provides clinical review support on an as-needed basis • Responsible for reviewing medical records for medical necessity, level of care, authorization compliance, and payer guideline alignment • Supports timely appeal submissions and inventory management while maintaining quality and compliance standards • Performs clinical reviews for medical necessity, level of care, and authorization-related denials • Reviews inpatient and outpatient medical records to support appeal submissions • Applies payer-specific guidelines and internal policies • Identifies documentation gaps and supports clear, defensible clinical narratives • Meets assigned turnaround times while maintaining quality standards • Documents review findings accurately in designated systems • Collaborates with clinical leadership as needed for escalations or complex cases

Role Description - Manage and maintain EHR systems, ensuring accuracy, organization, and usability - Build and optimize workflows, templates, and documentation structures within the EHR - Organize, tag, and structure historical medical records for easy access and analysis - Design and implement structured member journeys and touchpoints - Develop care plan templates, intake forms, and questionnaires - Translate complex healthcare data into structured, actionable workflows - Manage scheduling workflows within the EHR system - Ensure seamless coordination of appointments and member interactions - Leverage AI tools (preferably Claude) for process improvement, data structuring, and workflow efficiency - Organize and refine AI-generated clinical notes (e.g., AI scribe outputs) - Use AI to enhance operational efficiency not for creative tasks - Build standardized processes and clinical protocols - Maintain clear, structured documentation for all workflows - Continuously identify opportunities for system and process improvements - Conduct independent research to gather relevant local healthcare information - Support decision-making with accurate, data-driven insights Qualifications - 1-2 years of experience or background in clinical operations, care coordination, or healthcare administration - Experience in concierge, wellness, or high-touch healthcare environments - Familiarity with wearable health data integration - Strong communication skills. Clear, concise, and professional (client-facing readiness) - Proven experience managing EHR systems (non-billing focused) - Hands-on experience with EHR scheduling workflows - Process-driven mindset with the ability to explain workflows clearly - Experience using AI tools (Claude preferred) for structured, process-oriented tasks - Ability to organize and interpret healthcare data within systems - Experience creating templates, workflows, and structured documentation Requirements - Must be proficient in speaking and writing English very clearly - Must have relevant work experience - Be able to submit an NBI clearance and/or Local Police Clearance background check before onboarding [mandatory] - Must be available for video meetings with your camera on (when needed) Technical Requirements - Device: Reliable laptop or desktop computer. - Internet: High-speed connection (minimum 15 Mbps). - Audio: Noise-canceling headset. - Video: Webcam for virtual meetings. - Workspace: Quiet, professional environment. Benefits - Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication. - Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks. - HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients. - Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention. - Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule. - Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client. - Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best. - Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.