Remote Clinical Admin & Prior Authorization Specialist

Alliance Health; Charlotte (NC); Remote; USD 29,000 - 36,000; Full time

Benefits offered by this job

Medical, Dental, Vision, Life, Long --

Flexible work schedules includinghybr/

Generous retirement savings plan

Paid time off including vacation, sick

Dress flexibility

Job summary

Alliance Health is seeking an Administrative Clinical Support Specialist I to perform a range of administrative tasks, resolve problems, and coordinate support activities. The role involves transferring clinical data, pre-review of prior authorization requests, and completing discharge documentation in line with contractual and accreditation standards.

This full-time remote position requires residency in North Carolina, with occasional in-person reports to the Alliance Home Office in Morrisville

Qualifications

• High School diploma and four (4) years of related administrative experience to include a minimum of two (2) years performing administrative support functions, preferably within a clinical, health information, or healthcare administrative setting.
• Demonstrates consistent compliance in handling, accessing, transmitting, and storing sensitive clinical data and reports potential privacy or security concerns in accordance with established procedures.
• Demonstrates strong technical aptitude and efficiencies in navigating multiple platforms/portals to support daily operations.
• Knowledge of office management, including the ability to organize workflow and coordinate activities among department staff.
• Ability to perform calculations, summarize, compile and tabulate numerical material.
• Ability to maintain work standards and analyze/correct errors.
• Ability to maintain effective working relationships with employees and the public.
• Proficiency with databases and navigating SharePoint.
• Knowledge of NC Tracks & Alliance Medical Records electronic system.
• Ability to collaborate with multi-departmental and multi-unit teams.
• Proficiency in Microsoft Office products (Word, Excel, Outlook, etc.).

Responsibilities

• Triage, process, and gather clinical information to build prior authorization requests submitted via email/fax into our electronic health record platform.
• Support the UM department in ensuring notification to members and providers occur within required time frames.
• Adhere to HIPAA and organizational privacy and security policies to protect PHI.
• Utilize NC TRACKs to verify member eligibility in support of clinical and administrative workflows.
• Perform pre-screening of prior authorization requests and complete discharge documentation.
• Respond to providers inquiries related to PA status and UM procedures.
• Reference and adhere to agency policies and procedures to ensure regulatory compliance.

Skills

Data entry

HIPAA compliance

Multi-platform navigation

Office management

Numerical skills

SharePoint

NC Tracks

Microsoft Office

Education

High School diploma

Tools

Electronic health record system

Vendor portals

Job description

Alliance Health is seeking an Administrative Clinical Support Specialist I to perform a range of administrative tasks, resolve problems, and coordinate support activities. The role involves transferring clinical data, pre-review of prior authorization requests, and completing discharge documentation in line with contractual and accreditation standards.

This full-time remote position requires residency in North Carolina, with occasional in-person reports to the Alliance Home Office in Morrisville