What are the responsibilities and job description for the Clinical Services Coordinator, Advanced position at Blue Shield of California?
Your Role
Find out if this opportunity is a good fit by reading all of the information that follows below.
The MCS Clinical Service Intake team is responsible for timely and accurate processing of Treatment Authorization Request. The Clinical Services Coordinator (CSC), Advanced will report to the Supervisor of Clinical Services Intake. In this role you will be for supporting clinical staff day-to-day operations for Promise (Medi-Cal) or Commercial / Medicare lines of business.
Your Work
In this role, you will :
- Work in a production-based environment with defined production and quality metrics.
- Process Faxed / Web Portal / Phoned in Authorization or Hospital Admission Notification Requests, Utilization Management (UM) / Case Management (CM) requests and / or calls left on voicemail.
- Select support for Case Manager such as mailings, surveys.
- Data entry including authorization forms, high risk member information, verbal HIPPA authorizations information for case creation.
- Support to Intermediate and Specialist CSC.
- Assign initial Extension of Authority (EOA) days, or triage to nurses, based on established workflow.
- Research member eligibility / benefits and provider networks.
- Serves as initial point of contact for providers and members in the medical management process by telephone or correspondence.
- Assists with system letters, requests for information and data entry.
- Provides administrative / clerical support to medical management.
- Intake (received via fax, phone, or portal). Data entry including authorization forms, high risk member information, verbal HIPPA authorizations information for case creation.
- Provide workflow guidance to offshore representatives.
- Other duties as assigned.
Your Knowledge and Experience :
Your Pay
The pay range for this role is : $ 22.69 to $ 31.77 for California.
Note
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
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