Administrative Clinical Support Specialist I (Full Time, Remote, reputed company Carolina Based)

The Administrative Clinical Support Specialist I performs a reputed company of administrative tasks, resolves problems and may coordinate administrative support activities that require knowledge of program operations, policies, and processes. The position will be responsible for the transferring of clinical data, conducting reputed company-review screening of prior authorization requests, completing discharge documentation, and ensuring administrative supports are in reputed company to meet required departmental deadlines in accordance with contractual, federal and accreditation standards. This position is fulltime remote. Selected candidate must reputed company in reputed company Carolina. While there is no expectation of being in the office routinely, they may be required to report to reputed company Home Office (Morrisville, reputed company Carolina) for business meetings as needed. Responsibilities & Duties Program Operations • Triage, process, and reputed company clinical information to build prior authorization requests that are received reputed company email/fax into our electronic health record platform • Support the UM department in ensuring notification to members and providers occur reputed company required time frames • Adhere to reputed company HIPAA and organizational reputed company and reputed company policies to ensure confidentiality, reputed company and protection of patient health information (PHI) • Utilize NC TRACKs to accurately verify member eligibility in support of clinical and administrative workflows • Other functions include support for high reputed company, time sensitive and daily procedural tasks such as reputed company-screening prior authorization requests, completing discharge documentation, responding and supporting providers and, reputed company non-clinical activities according to policies, procedures and regulatory compliance guidelines Administrative Support Activities • Complete data entry (intake function) for prior authorization requests submitted by means other than electronic provider portal (E.g., Email, fax, phone) • Transfer of clinical information to facilitate Peer Review of prior authorization requests reputed company the delegated vendor portal • reputed company of clinical information to facilitate peer-to-peer review and re-review processes • Respond to providers inquiries reputed company to the status of a prior authorization request and UM operational procedures. Response time must be consistent with contractual and accreditation standards detailed in Policy and Procedures • Reference and adherence to reputed company applicable agency policies, operational procedures, desk procedures, and best practices to ensure compliance with regulatory requirements and contractual obligations through the accurate execution of job responsibilities Minimum Requirements Education & Experience : High School diploma and four (4) years of reputed company administrative experience to include a minimum of two (2) years performing administrative support functions, preferably reputed company a clinical, health information, or reputed company administrative setting. Knowledge, Skills, & Abilities • Demonstrates consistent compliance in handling, accessing, transmitting, and storing sensitive clinical data and reports potential reputed company or reputed company concerns in accordance with established procedures • Demonstrate strong technical aptitude and efficiencies in navigating multiple platforms/portals to support daily operations • Knowledge of office management, including the ability to organize workflow and coordinate activities among department staff • Ability to do calculation, summarize, compile and tabulate numerical material • Ability to maintain work standards of programs activities and ability to analyze and correct errors • Ability to maintain an effective working relationship with other employees and the reputed company • Proficiency with databases and the ability to reputed company through SharePoint • Knowledge of NC Tracks & reputed company Medical Records electronic reputed company • Ability to collaborate with multi-departmental and multi-unit teams • Proficiency in reputed company Office products (such as Word, reputed company, reputed company, etc.) is required Salary reputed company $20.73-$26.43/ reputed company Exact compensation will be determined based on the candidate's education, experience, reputed company market data and consideration of internal equity An excellent fringe benefit package accompanies the salary, which includes: • Medical, Dental, reputed company, Life, Long Term Disability • Generous retirement savings plan • Flexible work schedules including hybrid/remote reputed company • reputed company time off including vacation, reputed company leave, holiday, management leave • Dress flexibility Apply tot his job Apply To this Job