Clinical Support Coordinator 2

TALENT Software Services; Long Beach (CA); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

null

Job summary

TALENT Software Services is seeking support staff in Long Beach, CA to process and coordinate CalAIM Community Supports referrals, authorizations, and data entry. You will work with internal teams and external providers to enroll members and ensure timely reporting.

Responsibilities include reviewing screening documents, handling authorizations/denials, and maintaining accurate case records while following state and federal regulations.

Qualifications

• Detail-oriented—essential for accurate data handling and coordination.
• Experience working in electronic medical record systems.
• Experience with data entry and/or utilization management.

Responsibilities

• Review CalAIM Community Supports Screening documents to determine member eligibility for CalAIM Community Supports.
• Follow up with internal staff and providers to support referral and enrollment of members into CalAIM Community Supports services.
• Process daily service authorizations and denials for requested Community Supports services.
• Perform data entry, tracking and case documentation for all members referred for services.
• Support with reconciling provider invoicing and claims.
• Support with sending communications to Community Supports Providers to ensure timely submission of deliverables and reports.
• Support with implementation of CalAIM Community Supports training to internal teams, external providers, and community-based organizations.
• Identify and help address gaps/barriers in the care coordination process to improve member access to services.
• Review Provider reports to ensure accurate data collection and reporting.
• Respond to inquiries regarding service authorization request status.
• Actively participate in Multidisciplinary Team meetings to coordinate member care and support member retention.
• Conduct outreach calls to members to verify engagement in Community Supports services.
• Participate in ensuring that all state and federal rules and regulations are followed.
• Perform other assigned duties.

Skills

Detail-oriented

EMR systems

Data entry / utilization management

Education

High School Diploma or equivalent

Tools

Word

Excel

Outlook

Teams

Job description

Day to Day Responsibilities

(Being thorough in this section will allow the suppliers to pre-identify candidates more accurately.)

• Review CalAIM Community Supports Screening documents to determine member eligibility for CalAIM Community Supports.
• Follow up with internal staff and providers to support the successful referral and enrollment of members into CalAIM Community Supports services.
• Process daily service authorizations and denials for requested Community Supports services.
• Perform data entry, tracking and case documentation for all members referred for services, including enrollment status, authorizations, encounter data, care coordination activities, clinical case records and regulatory reports.
• Support with reconciling provider invoicing and claims.
• Support with sending communications to Community Supports Providers to ensure timely submission of deliverables and reports.
• Support with implementation of CalAIM Community Supports training to internal teams, external providers, and community-based organizations by providing ongoing education about CalAIM Community Supports services and referral process.
• Identify and help to address gaps/barriers in the care coordination process to improve member access to services.
• Review Provider reports to ensure accurate data collection and reporting.
• Respond to inquiries regarding service authorization request status.
• Actively participate in Multidisciplinary Team meetings to coordinate member care and support member retention in CalAIM Community Supports services.
• Conduct outreach calls to members, as needed, to verify engagement in Community Supports services.
• Participate actively in ensuring that all state and federal rules and regulations are followed.
• Perform other assigned duties, as required.

Required Skills (top 3 non-negotiables)

• Detail-oriented
• Experience working in electronic medical record systems
• Experience with data entry and/or utilization management

Preferred Skills (nice to have)

• Health Plan and/or Medi-Cal experience/knowledge
• Excellent written and verbal communication
• Interest/passion for social services delivery

Disqualifiers/Dislikes on Resumes

N/A but could provide feedback during reviews if something presents as a disqualifier.

Education Requirements

High School Diploma or equivalent

Required Testing

N/A

Software Skills Required

• Word
• Excel
• Outlook
• Teams

Required Certifications

N/A