Care Coordination Specialist (Medical)

BRMS; Folsom (CA); In loco; USD 52.000 - 76.000; Tempo pieno

Descrizione del lavoro

BRMS is seeking a Care Management Coordinator to support an assigned Medical Care Management Nurse. You will handle referrals, gather documentation, and coordinate with providers to ensure timely care and accurate records.

This role requires strong communication, HIPAA discipline, and proficiency with Microsoft Office. You will work in a team but also independently to meet daily deadlines and maintain data integrity within our care management system.

Competenze

• High school diploma or GED required; college degree preferred; and medical or insurance experience or equivalent demonstrated ability.
• Bilingual Spanish/English preferred; ability to read, speak and write English effectively.
• Ability to work independently and within a team, following policies and procedures.
• Strong knowledge of ICD-10, HCPCS and CPT coding and medical terminology.

Mansioni

• Work directly with assigned Medical Care Management Nurse.
• Contact members by phone, mail, or email as directed by Medical Care Management Nurse.
• Generate reports and documents pertaining to member case management.
• Act as liaison between reinsurance department and Nurse Care Management team regarding reports.
• Contact providers to obtain clinical documentation for members.
• Maintain HIPAA confidentiality and follow all internal policies and procedures.
• Review and process daily referrals for outpatient and inpatient care as needed to back up UR Coordinator.
• Remain in daily contact with other Care Management Department.
• Work independently on assigned tasks and activities per policies.
• Perform other duties as assigned by Management.

Conoscenze

Communication

Clinical documentation evaluation

Customer service

Organization

Microsoft Office

Medical terminology

ICD-10/HCPCS/CPT coding

Independent work

Evidence-based guidelines

DME knowledge

Formazione

High School diploma or GED

College degree preferred

Strumenti

Document scanning software

Windows-based software

Descrizione del lavoro

BRMS is seeking a Care Management Coordinator to support an assigned Medical Care Management Nurse. You will handle referrals, gather documentation, and coordinate with providers to ensure timely care and accurate records.

This role requires strong communication, HIPAA discipline, and proficiency with Microsoft Office. You will work in a team but also independently to meet daily deadlines and maintain data integrity within our care management system.