What are the responsibilities and job description for the Clinical Admin Coordinator position at Rose International?
JOB TITLE : Clinical Administrative Coordinator - Bilingual
JOB ID : 100452
DURATION : 3 months
HOURS : Standard
LOCATION : REMOTE - They will work remotely in El Paso but may need to go to the El Paso Health office from time to time for meetings or special events.
Required Qualifications
Education / Specialized Training / Licensure : High School Diploma or GED or Me.
2 years of experience working with MS Word, Excel, and Outlook.
Experience in long-term care, home health, hospice, public health or assisted living.
Bilingual language skills in Spanish and English
Live in the El Paso, TC area
Preferred Qualifications
Experience as a case management support staff, a customer service representative in a medical office or health plan, utilization review assistant preferred.
At least a 2-year college Associate’s Degree preferred.
Previous experience in a managed care environment preferred.
Previous experience with the State of Texas STAR PLUS program or similar programs dealing with SSI and disabled adults preferred.
Knowledge of the Medicare / Medicaid dual population preferred.
Job Summary
To assist provide the administrative support to Service Coordinator to assist in the delivery member services non-waiver and waiver, initiation of member contact, provision of member and provider education and coordination of community resources to promote optimal health.
Essential Duties and Responsibilities
Answers incoming fax, email and phone requests as evidenced by fax log, inbox, and event tracking.
Initiates member phone calls daily and identifies issues and refers to service coordinator and other health plan departments as indicated. Documents in current service coordination system.
Accurately schedules, cancels, and documents new and / or follow-up appointments for both face to face and telephonic requests, as needed for service coordinator and other designated team members as identified in service coordination system.
Receives initial incoming faxes, emails, or phone requests into the department, gathering demographic and benefit data, documenting in appropriate system, and evaluating if the request needs to be referred to a registered nurse, social worker, or transition specialist. This is determined through documented policy and procedure.
Screens and evaluates all calls and refers as necessary to service coordinator and / or supervisor.
Gathers data for statistics by product, service, and network and maintains all required logs.
Manages the intake of MNLOC and ISP request of identified members.
Monitors portal to ensure initial assessments and reassessments are completed timely.
Communicates in progress MNLOC reviews submitted.
Monitor portal for approval or denial decisions on MNLOC / ISPs
Document decisions into OICS and provides communication to the Service Coordinator of the outcome.
Update due dates for the ISP and MNLOC in service coordination system.
Completes all eligibility and benefit data available on members before routing to service coordinator or transition specialist.
Assists internal and external departments by providing communication and education regarding case management and transition services and processes.
Provides input on the availability and accessibility of case management and transition services.
Provides ongoing education with members regarding managed care and benefits.
Provides education to members regarding EL Paso Health network, access, community resources, and basis health information.
Knowledge and Skills
General business and computer knowledge, medical terminology training, some college course work, experience in health care / insurance environment,
Required for completely satisfactory performance in this job is the ability to operate a computer, word processing software, fax machine, photocopier, and multi-line telephone.
Excellent written and verbal communication skills required.
Customer service skills and phone etiquette are required.
Ability to handle high volume of inbound and outbound calls and perform more than one task at a time in a professional manner.
Experience in electronic charting
Only those lawfully authorized to work in the designated country associated with the position will be considered.
Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.
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