Alignment Health is breaking the mold in conventional health care committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we this fast-growing company you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters not only changing lives but saving them. Together.
Alignment Health is seeking a care coordinator located in North Carolina to join the remote Care Anywhere (CAW) team.General Duties / Responsibilities:
Manage (4) provider schedules ensuring that schedules are filled.
Prepare charts for upcoming home visit appointments (check member eligibility gather records needed by the provider prior to the home visit)
Conduct outreach for scheduling appointment confirmation calls wellness checks for high risk members and to providers / pharmacies for member needs.
Daily inbound / outbound call quota of minimum 60 - 80 calls / day.
Obtain medical records from provider offices hospitals and skilled nursing facilities (SNFs) and upload medical records to electronic medical records (EMR.)
Submit referral authorizations to independent physician associations (IPA) / medical groups for specialty durable medical equipment (DME) and home health (HH) services.
Coordinates lab orders and transportation for high-risk members.
Documentation via EMR for inbound / outbound calls.
Support SMS and member outreach campaigns.
Assist nurse practitioner (NP) team with visit preparation needs:
Appointment reminders to members
Assign members to NP in electronic health records (EHR)
Provide needed documentation to NP for visits each day
Direct inbound calls from members / family related to medication refills
Assist with maintaining and updating members records
Assist with mailing or faxing correspondence to primary care physician (PCPs) specialists related to as needed.
Attend CAW meetings / presentations and participates as appropriate.
Recognize work-related problems and contribute to solutions.
Work with outside vendors to provide appropriate care needs for members
Job Requirements:
Experience:
Required: Minimum 1 experience entering referrals and prior authorizations in a healthcare setting.
Preferred: Minimum 2 years healthcare experience.
Education:
Required: High School Diploma or GED.
Preferred: Completion of a Medical Assistant program from an accredited institution.
Training:
Preferred: Medical Terminology
Specialized Skills:
Required:
Able to communicate positively professionally and effectively with others; provide leadership teach and collaborate with others.
Knowledge of ICD9 and CPT codes
Knowledge of managed care plans
Strong computer skills
Proficient in Microsoft Office Suite (Outlook Excel Word)
Able to type minimum 35 words per minute (WPM)
Effective written and verbal communication skills; ability to establish and maintain a constructive relationship with diverse members management employees and vendors;
Knowledge working in Athena (not mandatory)
Language Skills: Able to read and interpret documents such as safety rules operating and maintenance instructions and procedure manuals. Able to write routine reports and correspondence. Communicates effectively using good customer relations skills.
Mathematical Skills: Able to add and subtract two-digit numbers and to multiply and divide with 10s and 100s. Able to perform these operations using units of American money and weight measurement volume and distance.
Reasoning Skills: Able to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Able to deal with problems involving a few concrete variables in standardized situations.
Problem-Solving Skills: Effective problem solving organizational and time management skills and ability to work in a fast-paced environment.
Preferred: Bilingual English and Spanish
Licensure:
Required: None
Preferred:
Medical Terminology Certificate
Medical Assistant Certification
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Pay Range: $38569.00 - $57853.00Pay range may be based on a number of factors including market location education responsibilities experience etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability age protected veteran status gender identity or sexual orientation.
*DISCLAIMER:Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal be advised that Alignment Health and its subsidiaries will never ask you for a credit card send you a check or ask you for any type of payment as part of consideration for employment with our you feel that you have been the victim of a scam such as this please report the incident to the Federal Trade Commission at If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Healths talent acquisition team please email.
Required Experience:
IC