Clinical Care Advocate

Bardavon; United States; On-site; USD 39,000 - 46,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401(k) with company match

Generous paid time off

Job summary

Bardavon Health Innovations is seeking a Clinical Care Advocate to support reauthorization of visits by processing physician scripts and plans of care from approved providers. You will maintain case documentation, coordinate with Visit Management Associates, and ensure seamless patient care transitions.

You will follow up referrals, obtain additional orders, and communicate claim status to stakeholders, while assisting Case Administrators and Coaching/QA as needed.

Qualifications

• High School Diploma or equivalent.
• Strong critical thinking skills.
• Strong communication skills, verbal and written.
• Proficiency in Microsoft Office Suite, CRM, Salesforce.
• Knowledge of Raintree, bNOTES.
• Proven ability to work both independently and cross-functionally within a team environment.
• Ability to anticipate problems and visualize solutions on a proactive basis.
• Ability to make decisions in the absence of detailed instructions and work independently or in a team environment.
• Flexible in the methodology, reliable, self-starter, results oriented.

Responsibilities

• Maintain accurate and timely documentation of cases by working with Visit Management Associates to track visit notes, claims, and coordinating upcoming medical visits or provider notifications as required by stakeholders.
• Follow up on all referral cases at the time of reauth to determine the plan of care.
• Obtain additional orders for cases continuing care and obtain authorization with required stakeholders.
• Work to ensure patients do not experience a lapse in care at the point of reauthorization.
• Advise stakeholders of claim status as needed for transparent and thorough communication.
• Execute tasks delegated to & from Case Administrators including questions/requests from stakeholders, case utilization reviews, and other requirements to support case management.
• Execute tasks delegated to & from Coaching/QA when additional visits are requested, utilization review is needed, or there are clinical questions from stakeholders.
• Optimize care management by delivering exceptional customer service and demonstrating empathy to support positive outcomes.
• Streamline workflows to enhance efficiency, improve case transparency, and facilitate effective communication among stakeholders.
• Use critical thinking and problem-solving skills as situations arise.
• Be detail oriented to ensure all information is entered and properly documented for managing the reauthorization.
• Work through queues efficiently and accurately to minimize delays in reauthorization processing.
• Communicate professionally, effectively and succinctly in verbal and written formats.
• Execute other duties/projects as assigned.

Skills

Critical thinking

Communication skills

MS Office

CRM

Salesforce

Raintree

bNOTES

Independent work

Cross-functional teamwork

Problem solving

Decision making

Self-starter

Reliability

Education

High School Diploma or equivalent

Tools

Microsoft Office Suite

CRM systems

Salesforce

Raintree

bNOTES

Job description

At Bardavon, we treat our people right. We hire exceptional people who are exceptional at their jobs. We are dreamers. We are driven, idealistic, committed, and optimistic. As a company, we are irreverent about the status quo and confident in our ability to change the Workers’ Compensation industry and healthcare in America.

Why Bardavon?

At Bardavon, we treat our people right. We hire exceptional people who are exceptional at their jobs. We are dreamers. We are driven, idealistic, committed, and optimistic. As a company, we are irreverent about the status quo and confident in our ability to change the Workers’ Compensation industry and healthcare in America.

What You’ll Do

The Clinical Care Advocate contributes to the department’s efforts to obtain and process reauthorization of visits based on physician scripts and signed plans of care from approved network providers in an organized and process-oriented manner that meets patient and customer expectations.

• Maintain accurate and timely documentation of cases by working with Visit Management Associates to track visit notes, claims, and coordinating upcoming medical visits or provider notifications as required by stakeholders.
• Follow up on all referral cases at the time of reauth to determine the plan of care.
• Obtain additional orders for cases continuing care and obtain authorization with required stakeholders.
• Work to ensure patients do not experience a lapse in care at the point of reauthorization.
• Advise stakeholders of claim status as needed for transparent and thorough communication.
• Execute tasks delegated to & from Case Administrators including questions/requests from stakeholders, case utilization reviews, and other requirements to support case management.
• Execute tasks delegated to & from Coaching/QA when additional visits are requested, utilization review is needed, or there are clinical questions from stakeholders.
• Optimize care management by delivering exceptional customer service and demonstrating empathy to support positive outcomes.
• Streamline workflows to enhance efficiency, improve case transparency, and facilitate effective communication among stakeholders.
• Use critical thinking and problem-solving skills as situations arise.
• Be detail oriented to ensure all information is entered and properly documented for managing the reauthorization.
• Work through queues efficiently and accurately to minimize delays in reauthorization processing.
• Communicate professionally, effectively and succinctly in verbal and written formats.
• Execute other duties/projects as assigned.

Must Have’s

• High School Diploma or Equivalent.
• Strong critical thinking skills
• Strong communication skills, verbal and written
• Proficiency in Microsoft Office Suite, CRM, Salesforce
• Knowledge of Raintree, bNOTES
• Proven ability to work both independently and cross-functionally within a team environment.
• Ability to anticipate problems and visualize solutions on a proactive basis.
• Ability to make decisions in the absence of detailed instructions and work independently or in a team environment.
• Flexible in the methodology, reliable, self-starter, results oriented

Nice To Have’s

• Medical Background
• Post-secondary education
• Bilingual Spanish

Compensation

• The range of base salary for this role is between $39,000 to $46,000 plus benefits. Please note that base salary is a guideline and will vary based on factors such as work location, qualifications, skill level, and competencies. Additionally, salary is just one component of Bardavon’s total rewards package. Depending on the role, employees may also be eligible for a bonus program and/or incentive pay.

We do Workers’ Comp differently.

Bardavon Health Innovations is a proactive Workers’ Compensation partner that connects all stakeholders to better manage claims and offer work readiness solutions through rehabilitation therapy. We share a holistic analysis of the claim so America’s injured workers can achieve optimized outcomes and return to full-duty employment.

Bardavon offers a complete benefits package, including medical, dental, and vision insurance; 401(k) with company match; and generous paid time off.

EOE M/F/D/