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Our Customer Service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.
Employees in this position include those responsible for initial Triage of members, Administrative Intake of members or managing the Admission/discharge information post-notification, and working with hospitals and the Clinical team. Function includes managing Incoming calls, managing requests for services from Providers/members, providing information on available Network services and transferring members as appropriate to Clinical staff. Also manages the Referrals process, processes Incoming and Outgoing Referrals, and Prior Authorizations. This function also includes Intake, Notification and Census roles.
This will be an on-site Clinical Administrative Coordinator at our office on Two Allegheny Center Suite 600 - Pittsburgh, PA 15212.
- Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance
- Drafting of NOA/NOE letters for government and Commercial Specific clients.
- Responsible for ensuring the letter documentation meets client, regulatory and accreditation requirements
- Knowledge of the State and Federal regulations concerning the services and benefits.
- Must demonstrate understanding of the program by selecting the correct letter template
- Other duties as assigned by manager and/or director