Health Services Coordinator (50076)

GLOBALHEALTH HOLDINGS LLC•Oklahoma City, OK

1d•Remote

About The Position

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

Requirements

High School diploma or equivalent and two years of data entry experience in an administrative support position required.
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

Nice To Haves

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

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.