Job Description

Adecco Healthcare & Life Sciences is hiring an Associate Clinical Administrative Coordinator! This role is remote / work from home. Please read below and apply with an updated resume for consideration.

Type: Five-month contract, opportunity for extension or fulltime offer
Schedule: Monday – Friday, 8am to 5pm
Pay: $19.50 to $21.05 an hour

Responsibilities of the Associate Clinical Administrative Coordinator :

• Provides non-clinical support to the CDU nurse in the processing of all adverse determinations and notices including provider outreach for denial avoidance, accessibility verification and benefit validation.

• Ensures informational notices for carve outs and benefits are composed in a manner consistent with federal regulations, state regulations, health plan requirements and NCQA standards.

• Converts service description and diagnosis into language that is easily understood based on resources provided and clinical direction.

• Validates the accuracy of all information provided in the carve out and benefit notices including carve out providers and contact information provided relevant to aforementioned notices.

• Contacts members or providers for continuity of care services related to carve out notices.

• Adheres to the standardized documentation requirements for carve out and benefit notices.

• Documents members’ service benefits by contacting the appropriate health plans.

• Directs providers and members to contracted provider network and facilities.

• Processes appropriate authorizations for HMO / PPO clients as specified in the organization’s procedures.

• Acts as a resource to other coordinators, staff and providers by resolving issues and responding to requests in a timely and effective manner.

• Works with patient services regarding member concerns.

• Identifies gaps in training or process impacting the overall compliance of adverse determinations and communicates in writing an effective performance improvement solution.

 

Qualifications for the Associate Clinical Administrative Coordinator :

Minimum:

• High School Diploma or GED required.

• 1 year of experience performing non-clinical functions for prospective UM review.

• Knowledge of medical terminology and CPT/ICD-9 coding.

Preferred:

• 1 year of experience providing supportive or direct functions for adverse determinations.

• 3 to 5 years of experience in a health care setting.

• 2 years referrals management or related experience.

Why work for Adecco?

• Weekly Pay

• 401(k) Plan

• Skills Training

• Excellent medical, dental, and vision benefits

Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.

IMPORTANT: This Associate Clinical Administrative Coordinator job is being recruited for by Adecco’s Healthcare & Life Sciences division, not your local Adecco Branch Office.

For opportunities available at Adecco Healthcare & Life Sciences go to

Equal Opportunity Employer/Veterans/Disabled. To read our Candidate Privacy Information Statement, which explains how we will use your information, please visit . The Company will consider qualified applicants with arrest and conviction record.

Pay Details: $19.50 to $21.05 per hour

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to />
The Company will consider qualified applicants with arrest and conviction records subject to federal contractor requirements and/or security clearance requirements.

Job Tags

Hourly pay, Weekly pay, Holiday work, Full time, Contract work, Temporary work, For contractors, Local area, Remote job, Work from home, Monday to Friday,

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