The Client Coordinator is responsible for servicing inquiries from clients, physicians, nurses or any representative acting on behalf of a client. This position is responsible for data preparation, data entry, data tracking, documentation and filing. All duties are handled with a high degree of quality customer service and in compliance with all regulatory and company standards.
Hours: Tuesday - Friday, 12:00 - 8:30pm EST; Saturday 10:00am - 6:30pm EST
Essential Job Functions
- Handle and respond promptly to inquiries from clients and/or anyone acting on behalf of the client regarding questions, report status, concerns, or general requests for information.
- Utilize appropriate systems and databases to enter client or claimant information and or retrieve information.
- Maintain daily contact with the QA department regarding workflow and pending report status.
- Contact providers for assignment and update database.
- File and archive open and closed cases.
- Verify all client information is current in the database and all client specific guidelines and or rules or information is documented in the system.
- Work independently and in partnership with other team members to ensure that questions are addressed, documented and cases are returned in a timely fashion.
- Direct calls to other departments as needed.
- Perform various clerical duties such as typing, filing, emailing, and proofreading.
- Assist in resolution of customer complaints and quality assurance issue.
- Notify management of any report issues or concerns.
- Ensure all practices are carried out in accordance with state and federal safety and legal regulations.
- Perform other duties as assigned.
MINIMUM REQUIRED QUALIFICATIONS
Education And/or Experience
High school diploma or equivalent required. Minimum one year clerical experience; or equivalent combination of education and experience preferred. Experience in a medical office or insurance industry preferred.
Certificates, Licenses, Registrations
No specific requirements.
Qualifications
ESSENTIAL COMPETENCIES
- Must possess complete knowledge of general computer, fax, copier, scanner, and telephone.
- Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
- Must have ability to be trained on and adhere to HIPAA regulations and compliance standards.
- Must be a qualified typist with a minimum of 40 W.P.M.
- Ability to follow instructions and respond to managements’ directions accurately.
- Must demonstrate accuracy, thoroughness, and responsibility for quality of work, and ability to take initiative to identify improvements. Looks for ways to improve and promote quality and monitors own work to ensure quality is met.
- Must demonstrate exceptional communication skills.
- Must be able to work independently, prioritize work activities and use time efficiently.
- Must be able to maintain confidentiality.
- Must be able to demonstrate and promote a positive team -oriented environment.
- Must be able to stay focused and concentrate under normal or heavy distractions.
- Must be able to work well under pressure and or stressful conditions.
- Must possess the ability to manage change, delays, or unexpected events appropriately.
- Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time.
- Ability to read, analyze and interpret common correspondence, medical records, and legal contracts and documents.
- Ability to write clearly and informatively to all required audiences and edit own work for appropriate spelling and grammar.
- Ability to respond appropriately and professionally to all inquiries or complaints from customers, physicians, regulatory agencies, and/or members of the business community.
- Ability to effectively present information one-on-one or in small groups.
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.
This Position Generally Consists Of
- Ability to work at a desk or similar office-type furnishings up to 8 hours a day or longer as required by business needs.
- Ability to operate a computer up to 4 hours at a time.
- Ability to travel to different floors of the office or other locations.
- Ability to move throughout the office.
- Occasionally lifting and/or carrying up to 10 lbs.
- Occasionally pushing/pulling up to 25 lbs.
- Occasionally subject to bending, squatting or twisting.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Extended hours are occasionally required beyond the regular eight (8) hour work day.
- The noise level in the work environment is usually moderate.
About the company
Company website•Hospitals and Health Care
MCMC’s Independent Peer Review program compliments your appeal, claims, prior-auth, utilization, and case management programs by providing the comprehensive physician expertise and driven service delivery you need to meet industry and regulatory standards for medical review.
MCMC’s range of services includes everything from pre-certification reviews to complex, high-tech policy reviews, and for health plans, insurance carriers, pharmacy benefit managers, self-funded employer groups, third-party administrators, hospitals, and state-mandated external review programs.
Independent Peer Review Turn to the source that most health plans rely on for their peer review services. MCMC is the source you can trust to provide premier service for all your peer review needs.
Peer Review Services
• Pre-certification/prior authorization
• Retrospective
• Appeals
• Concurrent
• Fraud and abuse
• Telephone conference/consultation
• Quality assessments
• Medical expert testimony
• Criteria review
• Legal Review
• Clinical trials
MCMC reviews address the following issues:
• Medical necessity
• Covered benefits based on plan language
• Experimental or investigational procedures
• Level of care
• Drug formulary compliance
• Employee leave assessment
• Alternative treatments
• Length of stay
• Impairment, work restrictions and limitations
• Procedural coding”