UM Clinical Services Assistant I in New York, NY at Beacon Health Options

Date Posted: 11/19/2019

Job Snapshot

Job Description

About the Position:

Beacon Health Options is seeking a dynamic Clinical Services Assistant to join our team in Manhattan, NY! The Clinical Services Assistant screens incoming member and provide calls/inquiries and take data to initiate cases; quotes accurate benefit and policy information on inpatient and alternative levels of care; handles complicated inquiries, educates provides/subscribers in the certification process, reconciles inconsistencies and procedural difficulties when necessary, and performs all data entry in the system.

Position Responsibilities:

  • Primary contact after customer service for provider questions involving single case agreements, authorizations, claims processes and technical assistance. Completes data entry for authorizations.
  • Determines the eligibility and benefit status of all participants. Builds reviews as required by workflows. Communicates with clinical team manager when barriers are identified to completing assigned tasks.
  • Responsible for the daily monitoring of assigned queues and immediate reporting of variance that include but are not limited to CMS calls; connect queues, and individual queues when directed by the Clinical Manager/Supervisor.
  • Record member/provider inquiries into the Connect system and completes administrative functions as necessary. Conduct provider searches and record findings including provider status.
  • Assist clinical care managers to locate community resources for referral purposes
  • Assist with reporting requirements when requested.
  • Responsible for sending and distributing clinical faxes per contract requirements and HIPAA policy. Monitors fax machines/servers for documents with PHI as well as functionality (paper loaded)
  • Other duties as assigned to allow Care Managers to focus on assessments and reviews.

Position Requirements:

  • Education: High School Diploma or GED equivalent required, AAS degree preferred
  • Relevant Work Experience: 3 years experience in a healthcare/insurance setting preferred

To Apply:

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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