Excellent communication and customer service skills
Attention to detail with proficient documentation and technology skills
Proficiency in Windows PC environment and data entry (40 WPM minimum)
High School Diploma or GED with two or more years of experience in medical assistant/office administration or healthcare administrative support
Requirements:
Provides support to Case Management staff performing non-clinical activities and assisting department management
Responsible for initial review and triage of Case Management tasks and for reviewing data to identify member needs and assist in implementing care plans
Screens members using Molina policies to identify appropriate medical services and coordinates required services in accordance with member benefit plan
Maintains accurate documentation and handles inquiries (phone calls, messages, and research) while ensuring confidentiality and regulatory compliance
Job description
Hours 8-5 PST, Monday - Friday
• Will the position be 100% remote? Yes
• Are there any specific location requirements? Must reside in WA
• Are there are time zone requirements? Member outreach will be in Pacific time, 8 a.m – 5 p.m.
• What are the must have requirements? Excellent communication/customer relation skills; attention to detail; proficiency in documentation; proficient in technology/computer skills
• What are the day to day responsibilities? Outbound calls to Medicaid members to identify medical/BH/Social Determinants of health needs followed by referral/assignment to appropriate team
• Is there specific licensure is required in order to qualify for the role? No
• What is the desired work hours (i.e. 8am – 5pm) 8-5, Monday through Friday
Will require dual monitors and a docking station.
Potential to go perm: I think there is a possibility we may need this position on a permanent basis; however, we need to get caught up first and then see where we are at, through the end of the 6 mos we have the temp staff. If it looks like will need the resource ongoing, I will request a permanent full time position. There just isn't a way to determine that until we get through our backlog.
Duties and Responsibilities (List all essential duties and responsibilities in order of importance) · Provides support to the Case Management staff performing non clinical activities and supporting the management
of the department. · Responsible for initial review and triage of Case Management tasks. · Reviews data to identify principle member needs and works under the direction of the Case Manager to implement
care plan. · Screens members using Molina policies and processes assisting clinical Case Management staff as they identify
appropriate medical services · Coordinates required services in accordance with member benefit plan. · Promotes communication, both internally and externally to enhance effectiveness of case management services
(e.g., health care providers and health care team members). · Runs reports to assist in coordination of case management needs. · Provides support services to case management team members by answering telephone calls, taking messages
and researching information. · Maintains accurate and complete documentation of required information that meets risk management, regulatory,
and accreditation requirements. · Protects the confidentiality of member information and adheres to company
Knowledge, Skills and Abilities ( List all knowledge, skills and abilities that are necessary to perform the job
satisfactorily) · Strong customer service skills to coordinate service delivery including attention to members/customers, sensitivity
to concerns, proactive identification and resolution of issues to promote positive outcomes for members · Demonstrated ability to communicate, problem solve, and work effectively with people · Working knowledge of medical terminology and abbreviations · Ability to think analytically and to problem solve. · Good interpersonal/team skills · Must have a high regard for confidential information · Ability to work in a fast paced environment · Able to work independently and as part of a team. · PC experience in Windows environment and accurate data entry at 40 WPM minimum. · Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA) · Ability to establish and maintain positive and effective work relationships with coworkers, clients, members,
providers and customers
Required Education:
High School Diploma or G.E.D.
Required Experience:
Two or more years experience as a medical assistant,
office assistant or other healthcare service administrative
support role.
