Administrative Clinical Support Specialist I (Full Time, Remote, North Carolina Based)

Alliance Health•Fayetteville, NC

2d•$21 - $26•Remote

About The Position

The Administrative Clinical Support Specialist I performs administrative tasks, resolves problems, and may coordinate administrative support activities requiring knowledge of program operations, policies, and processes. The role transfers clinical data, conducts pre-review screening of prior authorization requests, completes discharge documentation, and ensures administrative support is in place to meet departmental deadlines and contractual, federal, and accreditation standards. This is a full-time remote position for a candidate residing in North Carolina. Routine office attendance is not expected, although the employee may be required to report to the Alliance Home Office in Morrisville, North Carolina, for business meetings as needed.

Requirements

High school diploma.
Four years of related administrative experience, including at least two years performing administrative support functions.
Strong technical aptitude and efficiency navigating multiple platforms and portals.
Knowledge of office management, including organizing workflow and coordinating activities among department staff.
Ability to calculate, summarize, compile, and tabulate numerical material.
Ability to maintain program activity work standards and analyze and correct errors.
Ability to maintain effective working relationships with employees and the public.
Proficiency with databases and ability to navigate SharePoint.
Knowledge of NC Tracks and the Alliance Medical Records electronic system.
Ability to collaborate with multi-departmental and multi-unit teams.
Proficiency with Microsoft Office products such as Word, Excel, and Outlook.
Consistent compliance in handling, accessing, transmitting, and storing sensitive clinical data, and reporting potential privacy or security concerns according to established procedures.
Must reside in North Carolina.

Nice To Haves

Administrative support experience in a clinical, health information, or healthcare administrative setting.

Responsibilities

Triage, process, and gather clinical information to build prior authorization requests received by email or fax in the electronic health record platform.
Support the Utilization Management department in ensuring members and providers are notified within required time frames.
Follow HIPAA and organizational privacy and security policies to protect the confidentiality, integrity, and security of protected health information.
Use NC TRACKs to verify member eligibility in support of clinical and administrative workflows.
Support high-priority, time-sensitive, and daily procedural tasks, including pre-screening prior authorization requests, completing discharge documentation, responding to and supporting providers, and performing related non-clinical activities in accordance with policies, procedures, and regulatory compliance guidelines.
Enter data for prior authorization requests submitted through methods other than the electronic provider portal, such as email, fax, or phone.
Transfer clinical information through the delegated vendor portal to facilitate peer review of prior authorization requests.
Gather clinical information to facilitate peer-to-peer review and re-review processes.
Respond to provider inquiries about prior authorization request status and Utilization Management procedures within contractual and accreditation time frames.
Follow applicable agency policies, operational procedures, desk procedures, and best practices to meet regulatory requirements and contractual obligations through accurate execution of job responsibilities.