Clinical Support Coordinator
Clinical Support Coordinator
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Squirrel Hill Health Center (SHHC) is a Federally Qualified Health Center (FQHC) seeking a dedicated Clinical Support Coordinator to join our team. The ideal candidate will ensure that healthcare services medications or treatments are approved by insurance providers before they are administered. This role involves acting as a liaison between patients healthcare providers and insurance companies to streamline the authorization process.
The Clinical Support Coordinator will assist SHHC Providers in managing and maintaining electronic or paperbased forms to ensure accurate and complete data collection and documentation. This position requires prompt courteous professional and accurate interactions with SHHC patients to ensure the smooth flow of both people and information through the SHHC system. The role involves working inoffice with the ability to travel to other locations for coverage as directed.
Responsibilities:
- Authorization Management:
- Submit and follow up on prior authorization requests for medications procedures or treatments.
- Communicate with insurance companies to ensure timely processing of authorizations.
- Verify patients insurance coverage and benefits for specific services.
- Coordination:
- Collaborate with healthcare providers to gather necessary documentation and clinical information.
- Act as a liaison between patients healthcare providers and insurance companies.
- Notify providers and patients of approval or denial statuses including next steps for appeals if necessary.
- Documentation:
- Accurately document all communication actions and decisions related to prior authorizations and Provider forms distribution.
- Maintain compliance with HIPAA and other healthcare regulations.
- Problem Resolution:
- Resolve authorization delays or denials by communicating with insurance representatives.
- Analyze denial reasons and recommend appropriate followup actions.
- Customer Service:
- Provide clear and empathetic communication to patients regarding insurance requirements.
- Educate providers and staff about payer requirements and updates.
- Act as a liaison between patients physicians/NPs/PAs and other entities regarding Clinical Operations and patient needs.
- Obtain release of information to seek necessary records and ensure proper review and followup with physicians/NPs/PAs.
- Other Duties:
- Ensure forms comply with company industry or regulatory standards.
- Accurately promptly and consistently document all patient interactions in the Electronic Health Record.
- Maintain confidentiality and compliance with HIPAA.
- Refer patients to the Care Navigation Team for necessary social services.
- Coordinate clinics and other offsite prevention services as directed by SHHC Management.
- Perform other duties as directed.
Qualifications:
- High school diploma or GED required; associates degree or healthcarerelated certification preferred.
- 13 years of experience in a healthcare setting insurance verification or prior authorization.
- Knowledge of medical terminology ICD10 and CPT coding.
- Proficiency in using healthcare software systems and ability to learn new systems.
- Strong computer skills including proficiency in EHR Microsoft Word Teams Outlook and Excel.
- Ability to assess understand and react effectively to the unique needs of various patient populations served.
- Excellent critical thinking organizational interpersonal and communication skills.
- Attention to detail for design accuracy and compliance.
- Professional and effective communication with a wide range of clients in person and by telephone or Portal.
- Ability to manage work efficiently and consistently.
- Fluency in a second language is preferred.
- Must be able to work in any SHHC location onsite or remotely as needed.
- Must accommodate occasional schedule changes to provide patient care.
- CPR certification preferred but not necessary.
- Commitment to serving populations consistent with SHHCs mission.
- All CDC recommended vaccinations including annual Covid and Flu required.
Required Experience:
Manager
Employment Type
Full-Time
