Care Management Associate - Transplant & Care Coordination

CVS Health; Philadelphia (Philadelphia County); Remote; USD 25.000 - 49.000; Vollzeit

Zusammenfassung

CVS Health in Philadelphia is seeking a dedicated Medical Assistant to support the National Medical Excellence Program. The role involves coordinating inbound calls from providers and members, navigating systems like MedCompass and HRP, and documenting information accurately.

You will perform eligibility and benefits verifications, collaborate with the clinical team and transplant staff, and assist with precertification processes while protecting patient confidentiality and adhering to

Qualifikationen

• 2+ years' experience as medical assistant or equivalent.
• Proficient in Microsoft Office, especially Excel.
• Ability to communicate with diverse populations.
• Ability to collaborate in a team environment.
• Flexibility and ability to work independently.

Aufgaben

• Performs intake of calls from providers or members.
• Uses Aetna systems (MedCompass, HRP, ASD, CEC, ATV) to build and enter member information.
• Performs eligibility, COB, and benefits verification.
• Maintains accurate documentation and complies with risk, regulatory and accreditation requirements.
• Performs intake of calls from members or providers regarding services via telephone, fax, EDI.
• Processes referrals, makes outreach calls, and enters data as needed.
• Collaborates with clinical team, medical directors, claims and contacting staff.
• Communicates with transplant financial coordinator and initiates authorizations for kidney transplants.
• Builds shell cases for transplant, cellular therapy, and gene therapy requests.

Kenntnisse

Medical assistant experience

Microsoft Excel

Communication skills

Team collaboration

Independent work

Ausbildung

High School Diploma or GED

Associate Degree preferred

Tools

Microsoft Office

Jobbeschreibung

CVS Health in Philadelphia is seeking a dedicated Medical Assistant to support the National Medical Excellence Program. The role involves coordinating inbound calls from providers and members, navigating systems like MedCompass and HRP, and documenting information accurately.

You will perform eligibility and benefits verifications, collaborate with the clinical team and transplant staff, and assist with precertification processes while protecting patient confidentiality and adhering to