Clinical Services Clerk

KPH Healthcare Services•Town of De Witt, NY

10d•$18 - $18

About The Position

Scope of Responsibilities: Assist with the day-to-day operations of the clinical department of ProAct. Works under direct supervision and follows standard procedures to accomplish assigned tasks. Job Summary: Responsibility for assisting with the prior authorization process and with tasks to meet the clinical needs of ProAct clients and members. Works closely with Clinical Services Specialist to prioritize tasks and responsibilities.

Requirements

Must be available, and on-time for scheduled work shifts
Minimum: High School Diploma (or currently enrolled) or GED
Strong Communication Skills, must be able to effectively communicate both on the phone and in group setting
Strong Organizational Skills
Proficient in using Microsoft Excel, Word and Access
Must be able to work independently
Cooperation: Must work harmoniously and effectively with fellow employees, supervisors and other in contact with
Initiative: Must work within supervision guidelines and assume additional responsibilities
Flexibility: Must be willing to work variable work schedules, assist others as requested and available, and be willing to perform all assigned work
Adaptability: Must respond to new situations in a positive way, accept change, support new ideas, master new routines and grasp explanations, apply current knowledge in new environments and experiences
Involvement: Must enjoy the demands of the job and work with interest and enthusiasm
Customer Service: Must provide appropriate customer service (for Kinney customers, fellow employees and business partners), listen attentively to their needs and respond appropriately
Safety: Must take care of equipment and employ good safety habits
Leadership: Must gain acceptance of ideas and accomplish goals through subordinates, peers and teams
Drug test
Initial and continuous exclusion and sanction/disciplinary monitoring
Any and all additional eligibility requirements based on the specific position

Nice To Haves

Preferred: AS Degree or Higher
Preferred: mimimum 1 year experience as Rx Technician or Customer Service Representative in a health care related service.

Responsibilities

Assist in preparation, organization, and communication regarding prior authorization requests.
Provide Help Desk support, where appropriate, for questions regarding overrides or clinical system edits.
Responsible for working with Implementation Department for loading prior authorization data for new clients when appropriate.
Assist in preparation of member mailings for various cost containment/clinical programs.
Assist in finding most cost-effective channels for specialty medications and being sure medications are being filled through proper network channels.
Assist in the preparation, where appropriate, of reports or records of prior authorization activity including invoicing documents for client billing.
Assist in the development and updating of formulary documents or other clinical-specific documents.
Assist with the day-to-day operations of the ProAct Help Desk when needed.
Responsible for completing all mandatory and regulatory training programs
Perform other duties as assigned