Clinical Assistant

Job Summary

Supporting BlueCare Plus Clinical Review Managers, the full-time remote Clinical Assistant will serve as a key point of contact for providers and healthcare partners, assisting with authorization requests, responding to inquiries, and ensuring timely coordination of care.

Key responsibilities

• Screen and direct incoming calls and faxes for Utilization Management and Care Management, ensuring appropriate case referrals
• Investigate and resolve customer inquiries and claims while maintaining departmental goals and handling assigned projects
• Document and enter data for organization determinations and notifications, ensuring compliance with internal policies

Required qualifications

• High School Diploma or equivalent
• At least 1 year of customer service experience
• Proficiency in Microsoft Office (Outlook, Word, Excel, PowerPoint)
• Knowledge of medical terminology and understanding of Utilization Management and Care Management processes
• Ability to work independently and collaboratively in a fast-paced environment