Mass General Brigham logo
Mass General Brigham

Mass General Brigham connects a full spectrum of care across a system of academic medical centers, specialty and community hospitals, physician networks, a heal

Clinical Support Coordinator

Location

United States

Posted

3 days ago

Salary

$20 - $28 / hour

Seniority

Mid Level

No structured requirement data.

Job Description

Clinical Support Coordinator

Mass General Brigham

Role Description The Clinical Support Coordinator is responsible for providing administrative support to the Care Managers (CM) and processing authorizations and non-contracted provider referrals, notifications in accordance with established contractual, benefit, and clinical policies and guidelines within Epic, QNXT, and the provider portal. The primary accountabilities of the position include: - Research, analysis, adjudication, and data entry of service requests and notices received by fax, telephone, mail, email, or electronically. - Ensuring that service requests, notices, and acknowledgements are processed in a timely, accurate manner in compliance with performance standards regarding telephone service levels and authorization/referral turnaround time and quality. - Assisting in various care management and member outreach initiatives. - Researching demographic information, conducting surveys, generating reports, and other projects and duties as assigned. Essential Functions: - Provide support to UM Care Managers to ensure provider and member customer satisfaction. - Respond in a timely and accurate manner to internal and external customer inquiries regarding Mass General Brigham Health Plan and Clinical administrative policies and procedures. - Strong knowledge and understanding of processing requests per Medicare, Medicaid, and commercial lines of business. - Process outpatient and inpatient authorizations/referrals using appropriate criteria for approval. - Achieve and maintain compliance with telephone accessibility and authorization/referral performance standards. - Process online and faxed authorization requests using desktop procedures. - Upload clinical information to the appropriate authorization in Mass General Brigham Health Plan's online provider portal. - Enter and/or update clinical information as directed by Care Managers. - Lead and/or collaborate with other Mass General Brigham Health Plan departments in efforts to achieve success in member care/case management. - Provide support for various care management and member outreach initiatives. - Provide alternate coverage during staff absences and position vacancies, as directed. - Other duties as assigned with or without accommodation. Qualifications - High School Diploma or equivalent required. - At least 2-3 years of administrative assistant or secretarial experience required. - Proficiency in MS Office. - Ability to proofread and edit written documents. - Ability to use the phone system. - Managing one's own time and the time of others. - Strong verbal & written communication skills. - Strong interpersonal, written, and oral skills. - Ability to use standard office equipment. - Familiarity with medical terminology. Requirements - This is a remote role that can be done from most US states. - This is a full-time, Monday through Friday role with a 9:00 am to 5:30 pm ET schedule. - Scheduled Weekly Hours: 40. - Employee Type: Regular. - Work Shift: Day (United States of America). - Pay Range: $19.81 - $28.30/Hourly. - Grade: 3. Benefits - Competitive salaries. - Flexible work options. - Career growth opportunities. - Comprehensive benefits. - Recognition programs designed to celebrate contributions and support professional growth.

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