Clinical Support Associate II Health Integrated
THIS JOB HAS EXPIRED Description
Hours of Position: Monday - Friday, 11:30 am - 8:00 pm
JOB SUMMARY: This position is responsible for providing customer service and support to at least multiple clients by handling outpatient treatment review requests from providers, performing member benefit eligibility verifications, processing authorization requests in at least two client and/or internal clinical systems.
This position also will be responsible for providing timely outbound authorization notifications to providers and members, as well as preparing and delivering timely outbound review notifications to providers. Clinical Support Associate II is responsible for delivery of letters, both automated and manual, as well as processing claims inquiries and medical records. These additional skills are required for this position. Each Clinical Support Associate must ensure that all required data elements are captured in our clinical information management system, with special attention to HIPAA compliance, data quality and client satisfaction while handling calls from providers and members regarding behavioral health services. The Clinical Support Associate II position is also responsible for processing Single Case Agreements/Case Management Agreements, physician review notifications, and administrative tasks related to StayConnected program.
This position is responsible for:
Quality service delivery;
Maintaining quality, productivity and procedures as defined by applicable policies and procedures
Meeting all individual and team performance metrics, including but not limited to; call quality, average handle time, schedule adherence and attendance.
This is a full-time position that requires schedule flexibility to maintain customer satisfaction. Work hours may vary according to business demands as defined by company policies and procedures. Schedule changes may include changes in work hours and work days. Advance notification of scheduling changes will be provided in compliance with published policies.
This position is subject to mandatory paid overtime based on business factors that may change from time to time.
CORE COMPETENCIES: Building Customer Loyalty, Contributing to Team Success, Continuous Improvement, Tenacity
Education/License/Certification: High School Diploma or GED required. Two years of advanced education/college or graduation from an accredited business school preferred.
Experience: Minimum two years health insurance environment experience required. Experience in managed healthcare environment preferred. Multiple systems use; recent managed care; physician office; hospital business office or health care industry background in customer service desired. Knowledge of medical and/or behavioral terminology is preferred.
Demonstrated ability to type 50 words per minute with 90% accuracy while engaged in a telephone conversation
Demonstrated proficiencies with basic computer skills to include how to navigate, accessing of various programs and use of Microsoft Outlook email
Must be an effective communicator, both written and verbally ? able to clearly articulate information to both providers and members
Demonstrated success in a call center environment to include multi-tasking as well as the ability to focus singularly on the task at hand
Must be flexible, willing to accept changes occurring in a dynamic environment
? 70% Delivers professional customer service to members, providers, and clients in accordance with all policies and procedures. Must maintain or exceed minimum performance standards as defined in goals document. Basic standards include accuracy, call metrics, attendance, and customer satisfaction.
? 10% Performs all administrative functions as required in our contractual agreements with our clients.
? 10% Maintains current policy and procedure information by self-study of corporate resources; attending training sessions; and by seeking knowledge.
? 10% Accountable for creating and fostering a team environment through participation in team activities; individual morale; willingness to pitch in and help with special projects and to be a part of the solution.
||10008 North Dale Mabry |
Tampa, FL 33618
THIS JOB HAS EXPIRED