Clinical Administrative Support Associate

Overview
As a Clinical Administrative Support associate you will work as an important part of a team of health care professionals who provide telephonic care to employees and family members of our clients. Your administrative responsibilities will help facilitate the smooth operation of a Telephonic Nurse unit as you work closely with our nurses, clients, and outside healthcare providers and perform the following functions.
REQUIREMENTS
Assist Health Care Advocate with outbound calls for concurrent review cases to request clinical and obtain/verify discharge dates.

Assist Health Care Advocate with patient appeals process, including copying medical reports coordination of mailing information and tracking of timeline to assure compliance to DOL/ERISA requirements.

Manage overflow calls from Health Care Advocate and incoming calls including triage to appropriate Health Care Advocate, assist member as needed or set up cases as applicable.

Facilitate delivery and receipt of mail/faxes, to all Health Care Advocates and other nurse unit team members.

Assist with timely response to returned mail: obtain current mailing addresses and reprocess the information to the member/physician/facility or provider as applicable.

Assist with follow-up calls for verification of lab results appointments with Health Care Advocate and request for information
Set up cases for initial calls and/or from ETUMS (electronic Transmission of Utilization Management requests) based on standard trigger diagnoses list and forward to Team Lead for nurse assignment.

Obtain missing telephone numbers for cases, update case with current information and notification to Health Care Advocate of update.

Manages filing of Medical Records including case documentation of clinical received and/or filed, manage medical records log onsite and offsite tracking record.

Completion of REQL process for requests of medical records.

Special projects and other duties as assigned per Team Lead/Manager.

Experience/Education:

High school diploma required. Associate degree preferred.
2 years of experience in administrative support role.
Good knowledge of medical terminology and experience in the medical field.
Excellent typing skills.
Excellent oral/telephone communication skills.
Strong organizational skills.
Strong customer service focus.
Experience with productivity applications like MS Office or other Windows bases applications is a plus.

Education Requirements
– High School Diploma or equivalent


Apply online at www.shps.com/careers