Clinical Claims Care Coordinator I - A

Responsibilities

• Review onsite assessments for consistency and quality and collaborate with the field nurse.
• Obtain information from the field assessor to clarify information and provide the carrier with a thorough, high quality assessment product.
• Prepare professional, objective report for the insurance customer summarizing information from the assessment using company formats, when appropriate.
• Manages the clinical quality review for the completed assessments.
• Act with independent judgement following client and company policies and procedures.
• Complete telephonic and virtual interviews as need arises.
• Always provides prompt, courteous and excellent customer service to internal and external customers.
• Demonstrate effective communication skills, level of attentiveness and use of appropriate lines of authority.
• Promptly shares accurate and complete information to others who need it, based on HIPAA and legal documents regarding release.
• Perform work accurately and demonstrate ability to prioritize workload.
• Use supplies and other resources (i.e. equipment, computer systems, tools, energy, etc.) efficiently and effectively.
• Attend or is responsible for information given at meetings and through other organizational channels.
• Uphold the principles of compliance as outlined in the Code of Conduct, Employee Handbook and related policies and procedures.
• Supports and participates in the mandatory Corporate Compliance Program training initiative on an annual or more frequent basis, as required.
• Meet established quality and production expectations as established and communicated by the department.