Clinical Support Specialist

SPECTRAFORCE; California (MO); Remote; Full time

Job summary

SPECTRAFORCE is seeking a Clinical Support Coordinator 2 to work remotely in California. This role requires attention to detail and effective communication skills, and involves reviewing member eligibility for services, processing authorizations, and supporting internal staff for referrals. The position is full-time with a duration of over 6 months and a pay range of $19.00 to $20.00 per hour.

Qualifications

• Experience with data entry and/or utilization management is highly valuable.
• Listening and communication skills are essential for member engagement.
• Health Plan and/or Medi-Cal experience is a plus.

Responsibilities

• Review community supports screening documents for member eligibility.
• Process daily service authorizations for requested services.
• Support the referral and enrollment of members into community supports.

Skills

Detail-oriented

Data entry experience

Education

High School Diploma or equivalent

Tools

Word

Excel

Outlook

Teams

Job description

1 week ago Be among the first 25 applicants

This range is provided by SPECTRAFORCE. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$19.00/hr - $20.00/hr

Direct message the job poster from SPECTRAFORCE

Senior Recruiter at SPECTRAFORCE Technologies

Job Title: Clinical Support Coordinator 2

Location: Remote in California

Duration of the assignment: 6+ Months (Potential to extend or convert to a permanent role depending on the performance and business needs)

Shift timings: 8:30AM- 5:00PM Pacific Times.

The pay rate starts from $20/hour

Day to Day Responsibilities

• 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 trainings 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):

• Detailed-oriented
• Experience with data entry and/or utilization management

Preferred Skills (nice to have):

• Health Plan and/or Medi-Cal experience/knowledge
• Experience working in electronic medical record systems

Education Requirements: High School Diploma or equivalent

Software Skills Required: Word, Excel, Outlook, Teams

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Administrative

• Industries

  Pharmaceutical Manufacturing, Hospitals, and Hospitals and Health Care

Referrals increase your chances of interviewing at SPECTRAFORCE by 2x

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