Remote Call Center Clinical Coordinator Jobs in Arkansas

Educate members on benefit coverage, patient financials, and proper use of Health Plan systems and facilities

Orient and train new or less experienced staff through on-the-job training programs

Opportunity to make a positive impact on customer satisfaction and retention

Access to electronic medical records systems to efficiently assist customers

Advocate for customer needs and interests within the employer organization

Responsible for scheduling and coordinating appointments across departments

Capture and input as many details as possible in the Customer Relationship Management system for the next agent.

Demonstrate determination and persistence in meeting goals provided by management on a daily/monthly/annual basis.

Demonstrate technical competency and improve skills after receiving coaching.

Basic knowledge of Microsoft Office Suite (TEAMS, One-drive, SharePoint) is required.

1+ years of working experience in customer service or a related field is preferred.

Answer all incoming phone calls from customers in a professional and timely manner.

Maintaining knowledge of various health plan partner benefits, networks, CMS regulations and health plan partner policies

ICD-9/ICD-10 and CPT Knowledge Telecommuting Requirements:

Determining authorization or notification requirements

Preparing authorization cases for Medical Directors, Network Operations Nurses and Case Managers

Utilizing experience and judgement to plan, accomplish goals and effectively resolve each assigned task

Managing authorizations / notifications and other service requests received via incoming phone calls, faxes and portal submission

Manage the clinical placement process by determining site-specific requirements and communicate these to student in a timely manner

Bachelor’s Degree from a four-year college or university or equivalent combination of education and experience

Collaborate with MedCerts staff to resolve student concerns of clinical requirements

At least three years of closely related experience

Strong interpersonal and communication skills

Experience with design and implementation of business development strategy

Advises callers of the Utilization Management certification requirements based on client information located on the HCM Group Matrix and within TruCare.

Offers to connect callers to the benefit department for clarification of plan benefits

Retrieves data from vendor portals and inputs information into TruCare to initiate a utilization review and/or case management referral when appropriate.

Other duties and special projects as needed/assigned by HCM Management.

Speak effectively with clients, physicians, providers, families in crisis and community agencies as well as co-workers and senior management;

Completes voicemail transcription from the queue and returns calls for confirmation of data and initiation of the certification processes as appropriate.