Job Description

About the job Clinical Assistant


Clinical Assistant needs 1 years experience in a customer service support role is required

• Possible COVID-19 vaccine mandate.

• Customer service support role is required

• Certifications

• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.

• Proficient interpersonal and organizational skills

• Independent, Sound decision-making and problem-solving skills

• Healthcare environment

• Provider reimbursement methodologies, ICD-9-CM, CPT, HCPCS and UB-92 coding, UHDDS coding guidelines, AHA Coding Clinic

• Must be able to work in an independent and creative manner.

• Self-motivated and able to manage multiple tasks and set priorities.

• Effective time management skills

• Excellent oral and written communication skills

• Strong interpersonal and organizational skills

• Knowledge in Medical terminology

• Various immunizations and/or associated medical tests may be required

• Supports area clinical team and serves as a proactive resource for members related to disease prevention and benefit education.

• Conduct educational telephone calls advising members of available benefits, services and programs; completes health needs assessment, and refers members to population health management programs as appropriate.

• Reach out to members with identified gaps in care; encouraging and motivating them to become compliant; offering assistance in locating providers and appointment scheduling.

• Manage system work queues; screening identified members for eligibility, prior case activities, recent claims, customer service inquiries and authorization history; assigning members to clinical team for call outreach and intervention.

• Facilitate research and analysis of inquiries and/or complaints related to processes and designations, member lost incentives, and other program related inquiries

• Work overtime as needed

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