Health Services Coordinator (51680)

GLOBALHEALTH HOLDINGS LLC•Oklahoma City, OK

1d•Remote

About The Position

This position provides administrative support for utilization review, health education, and care management. The role involves data entry, and communication with members, providers, and vendors for education and information gathering, all under the direction of the Supervisor, Health Services Coordination.

Requirements

High School diploma or equivalent
Two years of data entry experience in an administrative support position
Strong attention to detail
Excellent communication skills, Clear and effective written and verbal
Organization and time management skills, including ability to prioritize tasks.
Strong working knowledge of Microsoft Word, Visio, Excel and Power Point.
Ability to work independently and with a group.
Self-motivated
Excellent customer service skills
Demonstrated knowledge of managing the use of a SharePoint site or equivalent application
Must have access to a reliable and secured internet connection source.
Work environment must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy.
This position will also be required to use reasonable and necessary safeguards to protect GlobalHealth records from unauthorized access, disclosure or damage and will adhere to all GlobalHealth privacy and security policies.

Nice To Haves

Experience working with medical records
Experience working in managed care or utilization management environment
Strategic and Analytic thinking
Lean Six Sigma Green belt or Black belt

Responsibilities

Following Medicare/Medicaid Timelines for Notification to Provider/Members to meet department goals and requirements.
Verbal and/or written outreach to members and/or providers to provide updates on referral request status, reasoning behind decisions, and provide accurate information.
Daily Mail fulfillment – faxes to provide notification to provider or member of decisions.
Coordination of services for members, including community resources and collaboration with assigned case manager.
Develop and maintain resources related to the department.
Support departmental initiatives.
Identify and report process improvement opportunities.
Manage and document member and provider calls.
Enter authorization requests in the medical management systems.
Process member notifications.
Must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy.
Performs other duties as assigned.