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Form of work**This Job Posting is for Pipelining Future Opportunities**
By applying to this job, you will join our talent pipeline, allowing us to consider you for future openings.
Overview of the Role:
Alignment Health is seeking an compassionate, organized, and detail oriented remote Care Coordinator, Chronic Kidney Disease (CKD) to join the team and be responsible for UM / CM Coordinator functions as defined below.
Responsibilities:
- Conduct daily calls to nephrology clinics, PCP offices, and dialysis facilities. (75% of the position is making calls, asking questions regarding treatment, and comfortable with speaking with physicians)
- Able to research and update labs from Quest, hospital notes, or other sources for accurate CKD stage.
- Review daily census for new admissions
- Obtain medical records from provider offices, hospitals, and SNF's
- Attach medical records to authorizations
- Monitor fax folders
- Follow-up scheduling and rescheduling of no-show appointments
- Assist nurse practitioner (NP) team with visit preparation needs
- Appointment reminders to members
- Assign members to NP in electronic health records (EHR) system.
- Enter all medications and allergies in EHR.
- Provide needed documentation to NP for visits each day
- Maintain documentation on members contacted.
- Notify NP / nurse if members appear to be non-compliant or there appears to be a change in condition
- Assist with outreach activities to members in all levels of case management programs.
- Assist with maintaining and updating member's records
- Assist with mailing or faxing correspondence to PCP's, specialists, and related.
- Attend and participate in case management presentations.
- Recognize work-related problems and contribute to solutions.
- Meet specific deadlines (respond to various workloads by assigning task priorities according to department policies, standards and needs).
- Work with external vendors to provide appropriate care needs for members
- Maintain confidentiality of information between and among health care professionals.
- Communicate with multidisciplinary teams
- Cover for other team members when needed (i.e. PTO, sick time)
Required Skills and Experience:
- Minimum 1 year front office medical assistant, related experience, and / or training; or equivalent combination of education and experience.
- Experience entering referrals and prior authorizations highly preferred
- High school diploma or general education degree (GED)
- Medical terminology certificate preferred
- Knowledge of medical terminology
- Knowledge of ICD9 and CPT codes
- Knowledge of Managed Care Plans
- Computer proficient
- Able to type minimum 40 words per minute (WPM)
- Proficient in Microsoft Office Suite (Outlook, Excel, Word)
- Bilingual English and either Spanish or Vietnamese required.
- Knowledge working in Access Express / Portal, Epic, Essette preferred
- Good written, verbal,and telephonic communication skills
- Language Skills: Able to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ableto write routine reports and correspondence. Communicates effectively using good customer relations skills.
- Mathematical Skills: Ableto add and subtract two-digit numbers and to multiply and divide with 10's and 100's. Ableto perform these operations using units of American money and weight measurement, volume, and distance.
- Reasoning Skills: Ableto apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ableto deal with problems involving a few concrete variables in standardized situations.
- Good organizational skills
- Able to reason and carry out instructions.
- Good interpersonal skills.
- Read, write, and speak English fluently.
- File systematically.
Pay Range: $40,000 - $60,000 annually.
