Job Posting: Clinical Assistant

Number of Positions: 1

System Location: CWR

Created Date: 9/25/2023

Job Title: Clinical Assistant

CWR Type: W-2

Reason: New Position

Start Date: 10/16/2023

End Date: 1/26/2024

Job Profile Summary: The Clinical Assistant is responsible for supporting customer service activities and initiatives for a range of products or clients, including but not limited to the Case Management and Utilization Management departments.

Job Qualifications:

Education:

• High School Diploma or equivalent

Experience:

• 1 year of customer service experience is required

Skills/Certifications:

• Proficiency in Microsoft Office (Outlook, Word, Excel, and PowerPoint)
  Proficient oral and written communication skills
  
  Proficient interpersonal and organizational skills
  
  Exceptional time management skills
  
  Ability to work independently under general supervision and collaboratively as part of a team in a fast-paced environment
  
  Independent, sound decision-making, and problem-solving skills
  
  If a current employee with the company, must meet minimum performance expectations
  
  Extensive knowledge of all aspects of Utilization Management, Care Management, and Behavioral Health
  
  Knowledge and understanding of medical terminology
  
  Solid knowledge and understanding of provider reimbursement methodologies, ICD-9-CM, CPT, HCPCS, and UB-92 coding, UHDDS coding guidelines, AHA Coding Clinic
  
  Ability to talk and type simultaneously in a clear and concise manner while interacting with customers

Responsibilities:

Job Description:

Job Responsibilities:

• Screen incoming calls, faxes, or other digital formats for UM and/or CM and direct calls/faxes/other digital requests to the appropriate area. Identify and refer cases appropriately to the Case Management and/or Transition of Care department.
  Receive, investigate, and resolve customer inquiries and claims. Maintain departmental goals. Perform projects, review and handle reports as assigned.
  
  Load complete organization determination/notification for services designed by internal policy. Clearly document and key data into the appropriate system using departmental guidelines.
  
  Interact with membership, hospital, and provider staff, advising of UM decisions, status organization determinations, giving direction as necessary.
  
  Search for and key appropriate diagnosis and/or procedure code as part of the notification/prior authorization process.
  
  Must be able to pass required testing.
  
  Participation and attendance are mandatory.
  
  This position requires flexibility due to rotations in schedules and requires adherence to assigned schedules.
  
  Work overtime as required

Location: 1 Cameron Hill Circle, Chattanooga, TN 37402 , United States

Note: All applicants will be advised that , as a federal contractor, may be required to implement a COVID-19 vaccine mandate.