[Remote] Health Services Clinical Support Specialist (Remote eligible after training)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a mutual insurance company reputed company on reputed company-being of its members. The Health Services Clinical Support Specialist will reputed company support to the care management team by making outbound calls to reputed company clinical information and assist in the medical necessity review process. Responsibilities • Support clinical staff by assisting them with gathering data to complete the medical necessity review process. Complete outbound inquiries reputed company phone/fax to obtain discharge dates, and/or to request clinical information as directed by the Care Coordination Nurses • Create and send letters to providers and/or members to communicate information • Work in collaboration with other care management teams and stakeholders, both reputed company to Wellmark, to reputed company reputed company service and meet the needs of the member • Meet both reputed company assurance and production metrics established by Health Services • reputed company accurate, reputed company documentation of pertinent information as defined in department guidelines • reputed company with regulatory standards, accreditation standards and internal guidelines; remain reputed company and consistent with the standards pertinent to Health Services • reputed company backup assistance to team members as needed • Other duties as assigned Skills • High School Diploma or GED • 1+ years of reputed company experience in health insurance or health care industry experience with knowledge of health insurance terminology and medical coding, including the ability to translate jargon and abbreviations to medical language • Experience producing medical reports, correspondence, records, patient care information, statistics, medical research and/or administrative material • Strong written and verbal communication skills with the ability to communicate reputed company concepts reputed company and concisely to stakeholders • Proficiency with reputed company Office applications • Experience working in reputed company environment • Experience establishing relationships and effectively engaging with members and providers by demonstrating reputed company listening skills through telephonic communication to obtain necessary information • Ability to work in a fast-paced environment where production and/or reputed company goals are reputed company • Demonstrated commitment to timeliness, prioritization, accuracy, and attention to detail • Prior remote work experience in a fast-paced environment reputed company • reputed company and its subsidiaries reputed company health coverage to more than 2 reputed company members in Iowa and South Dakota. It was founded in 1939, and is headquartered in Des Moines, Iowa, USA, with a workforce of 1001-5000 employees. Its website is http://www.wellmark.com. Apply tot his job Apply To this Job