Job ID: 52658
Location: Morrisville, NC
Experience: At least 3 year(s)
Education: See Requirements
ABOUT THE POSITION
We are currently seeking a dynamic part-time Clinical Services Assistant II to join Central Night Service (CNS) Team. The Clinical Services Assistant II serves as the primary support mechanism for all non-clinical administrative tasks so that clinical staff may focus on clinical priorities and ensure that critical business needs are met.
Responsible for ambulatory follow up procedures to ensure that members have access to aftercare providers and receive the assistance they may need to reschedule appointments. This includes completing all protocols related to follow up activities and survey requirements such as placing follow up phone calls to facilities, members and providers confirming reviews, verifying appointment attendance. This may also include discharge planning coordination calls and distribution of outreach letters.
Primary contact after customer service for provider questions involving single case agreements, authorizations, claims processes and technical assistance
Determines the eligibility and benefit status of all participants. Builds reviews in the connect system as required by workflows. Communicates with clinical team manager when barriers are identified to completing assigned tasks.
Responsible for the daily monitoring of assigned queues and immediate reporting of variance that include but are not limited to CMS calls; connect queues, and individual queues when directed by the Clinical Manager/Supervisor.
Record member/provider inquiries into the Connect system and completes administrative functions as necessary. Conduct provider searches and record findings including provider status.
Assist clinical care managers to locate community resources for referral purposes
Primary contact for building and authorizing outpatient cases for members and providers through the registration process and the screening criteria tool.
Assist with reporting requirements when requested.
Other duties as assigned to allow Care Managers to focus on assessments and reviews.
Education: High School Diploma required plus three years of experience working in a healthcare environment with a high level of customer service. AA degree and four years of experience preferred.
Licensure: None Required
Relevant Work Experience: At least three years of progressive experience in customer service or healthcare required.
Knowledge, Skills & Abilities:
Basic Computer skill are required
Knowledge of Microsoft Office Products
Click below on 'Apply for this Position' to create a profile and apply for the position.
Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled.