* Overtime may be required. Advanced notice will be provided.*
Provides administration and department support for care management and clinical teams. Coordinates services and performs administrative functions. Assists in completing activities related to various cross functional projects in support of departmental goals.
Additional Responsibilities:Candidate Education:
- Responds to phones as assigned or team coverage as directed by Supervisor.
- Provides technical and administrative support to clinical and behavioral staff as needed.
- Assists, completes and submits special projects, reports or assignments to meet department needs and objectives.
- Serves as a liaison in corresponding and communicating with providers, vendors and WellCare contacts and/or members representative's.
- Produces, formats and edits correspondence and documents.
- Organizes a variety of administrative and clinical tasks and prioritizes in order of importance and impact on members and providers.
- Interacts with other departments including Claims, Intake, Enrollment and Member Services to resolve member and provider issues.
- Participates and supports tasks, including but not limited to: faxes, discharge preparations, request and/or collection of clinical information, engaging/contacting providers and creation of authorizations if necessary.
- Performs other duties as assigned.
- Required A High School or GED
- Preferred An Associate's Degree in a related field
- Required 3 years of experience in a managed care setting, medical office or facility setting with demonstration of medical administration duties
- Required Other In Behavioral Health, 3 years in performing administrative and/or clinical responsibilities in a medical, behavioral, or non-medical setting with demonstration of administrative duties (clerical, admin asst)
- Strongly preferred Experience with Authorizations and/or Utilization Management
- Intermediate Knowledge of medical terminology and/or experience with CPT and ICD-9 coding
- Intermediate Demonstrated interpersonal/verbal communication skills
- Intermediate Demonstrated written communication skills
- Intermediate Ability to effectively present information and respond to questions from peers and management
- Intermediate Ability to multi-task
- Intermediate Other Work effectively within group to achieve desired outcomes
Licenses and Certifications:
A license in one of the following is required:
- Preferred Licensed Practical Nurse
- Required Intermediate Microsoft Outlook Proficient in Microsoft Office such as Outlook, Word and Excel
- Required Intermediate Microsoft Excel
- Required Intermediate Microsoft Word