Clinical Support Specialist / Medical Assistant

About the Organization

Hunter Health provides all-encompassing care for the Wichita community, including medical, dental, behavioral, vision, laboratory, radiology, and pharmacy services, all in one place. We pride ourselves in providing the support patients need to take control of their health and their whole wellbeing. Our team is at the heart of our operations, living our mission and upholding our positive work environment with our Standards of Culture. We exist to improve the health and wellbeing of everyone in our community.

About the Role

The Clinical Support Specialist/Medical Assistant (CSS/MA) provides support and quality care in collaboration with medical providers, behavioral and mental health staff, and nursing staff. The CSS/MA supports the Director of Clinical Services and Nurse Manager to provide quality medical care to all Hunter Health Clinic (HHC) patients while maintaining compliance with all federal grants, HRSA, CMS, HIPAA, and HHC policies and procedures.

Responsibilities

• Coordinates prior authorizations for medications, imaging, procedures, durable medical equipment (DME), specialty services, and other payer-required services, ensuring requests are complete, accurate, and submitted within required timeframes.
• Monitors authorization requests, follows up with insurance carriers, communicates approval or denial outcomes to providers, staff, and patients, and coordinates appeals when appropriate.
• Assists with coordination of referrals to specialists, diagnostic testing, therapy services, and community resources, obtaining required authorizations, transmitting documentation, tracking referral completion, and ensuring records are incorporated into the electronic health record (EHR).
• Manages assigned telephone encounters, electronic messages, and provider inbox workflows by resolving appropriate administrative requests, routing clinical concerns to licensed staff, documenting patient communications, and maintaining established service standards.
• Assists with processing prescription refill requests in accordance with organizational procedures by reviewing requests for completeness, coordinating with pharmacies, and communicating refill status and follow-up instructions to patients.
• Verifies patient insurance eligibility, benefits, coverage, and authorization requirements while educating patients on insurance processes and collaborating with Revenue Cycle staff to resolve coverage or reimbursement issues.
• Coordinates and receives external medical record requests to further assist with scheduling diagnostic testing and specialty appointments.
• Supports continuous improvement in quality, care coordination, and workflow initiatives through patient interactions, documentation management, and identification of opportunities to improve efficiency, provider support, and patient access.
• Maintains accurate and timely documentation of authorizations, referrals, patient communications, and clinical support activities.
• Develops and maintains collaborative working relationships with providers, nurses, Medical Assistants, Pharmacists, Integrated Care Consultants, Revenue Cycle staff, insurance carriers, and community partners, while providing exceptional patient care.
• Participates in departmental meetings, organizational initiatives, required education, and compliance training.
• Travels when necessary to meet organizational needs.
• Performs all other duties as assigned.

Physical and Mental Demands

• Talking: The ability to speak clearly and effectively.
• Average Hearing: The ability to hear average conversations and respond accordingly.
• Repetitive Motion: The ability to sit, stand, walk, and use hands to handle, feel, and reach.
• Finger Dexterity: The ability to use fingers to make small movements such as typing, picking up objects, and pinching fingers together.
• Average Visual Abilities: The ability to focus on items clearly, including close vision, color vision, and the ability to adjust focus.