Clinical Administrative Coordinator
Job Summary
Working remotely on a full-time basis, the Clinical Administrative Coordinator will manage the initial triage of clinical claim reviews, verify member eligibility, and prepare cases for nurse review while utilizing departmental resources.
Key responsibilities:
- Access and verify claims information in the claims payment system
- Determine the necessity of Medical Claim Review for services using departmental resources
- Create and send clinical letters to providers as directed by nurses
Required qualifications:
- High School Diploma/GED or equivalent work experience
- At least 1 year of medical claims review or claims processing experience
- Ability to type 45 words per minute
- Proficiency in Microsoft Office Suite (Word & Outlook)
- Flexibility to work any shift during normal business hours of 8:00 am - 4:30 pm
Complete Job Description
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