Job Summary
A company is looking for a Managed Care Coordinator I to support Clinical Operations functions and act as a liaison among various stakeholders.
Key Responsibilities:
- Review service requests for completeness and collect necessary clinical and non-clinical data
- Prepare and document cases for clinical review, coordinating with members and providers
- Assist members with provider access, problem resolution, and health assessments
Required Qualifications:
- High School Diploma/GED required
- 1-2 years of experience in customer service or a medical support-related role preferred
- Knowledge of medical terminology required; Medicaid CM knowledge preferred
- Familiarity with contracts, enrollment, billing, and claims coding/processing preferred
- Understanding of Managed Care principles preferred
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