• Clinical Support Coordinator

    Squirrel Hill Health Center (Pittsburgh, PA)


    Squirrel Hill Health Center (SHHC), is a Federally Qualified Health Center (FQHC), seeking a dedicated Clinical Support Coordinator to join our team. ​The ideal candidate will ensure that healthcare services, medications, or treatments are approved by insurance providers before they are administered. ​This role involves acting as a liaison between patients, healthcare providers, and insurance companies to streamline the authorization process.

     

    The Clinical Support Coordinator will assist SHHC Providers in managing and maintaining electronic or paper-based forms to ensure accurate and complete data collection and documentation. ​This position requires prompt, courteous, professional, and accurate interactions with SHHC patients to ensure the smooth flow of both people and information through the SHHC system. ​The role involves working in-office, with the ability to travel to other locations for coverage as directed. ​

    Responsibilities: ​

    + Authorization Management: ​

    + Submit and follow up on prior authorization requests for medications, procedures, or treatments. ​

    + Communicate with insurance companies to ensure timely processing of authorizations. ​

    + Verify patients' insurance coverage and benefits for specific services. ​

    + Coordination: ​

    + Collaborate with healthcare providers to gather necessary documentation and clinical information. ​

    + Act as a liaison between patients, healthcare providers, and insurance companies. ​

    + Notify providers and patients of approval or denial statuses, including next steps for appeals if necessary. ​

    + Documentation: ​

    + Accurately document all communication, actions, and decisions related to prior authorizations and Provider forms distribution. ​

    + Maintain compliance with HIPAA and other healthcare regulations. ​

    + Problem Resolution: ​

    + Resolve authorization delays or denials by communicating with insurance representatives. ​

    + Analyze denial reasons and recommend appropriate follow-up actions. ​

    + Customer Service: ​

    + Provide clear and empathetic communication to patients regarding insurance requirements. ​

    + Educate providers and staff about payer requirements and updates. ​

    + Act as a liaison between patients, physicians/NPs/PAs, and other entities regarding Clinical Operations and patient needs. ​

    + Obtain release of information to seek necessary records and ensure proper review and follow-up with physicians/NPs/PAs. ​

    + Other Duties: ​

    + Ensure forms comply with company, industry, or regulatory standards. ​

    + Accurately, promptly, and consistently document all patient interactions in the Electronic Health Record. ​

    + Maintain confidentiality and compliance with HIPAA. ​

    + Refer patients to the Care Navigation Team for necessary social services. ​

    + Coordinate clinics and other offsite prevention services as directed by SHHC Management. ​

    + Perform other duties as directed. ​

    Qualifications: ​

    + High school diploma or GED required; associate’s degree or healthcare-related certification preferred. ​

    + 1-3 years of experience in a healthcare setting, insurance verification, or prior authorization. ​

    + Knowledge of medical terminology, ICD-10, and CPT coding. ​

    + Proficiency in using healthcare software systems and ability to learn new systems. ​

    + Strong computer skills, including proficiency in EHR, Microsoft Word, Teams, Outlook, and Excel. ​

    + Ability to assess, understand, and react effectively to the unique needs of various patient populations served. ​

    + Excellent critical thinking, organizational, interpersonal, and communication skills. ​

    + Attention to detail for design accuracy and compliance. ​

    + Professional and effective communication with a wide range of clients in person and by telephone or Portal. ​

    + Ability to manage work efficiently and consistently. ​

    + Fluency in a second language is preferred. ​

    + Must be able to work in any SHHC location onsite or remotely as needed. ​

    + Must accommodate occasional schedule changes to provide patient care. ​

    + CPR certification preferred but not necessary. ​

    + Commitment to serving populations consistent with SHHC’s mission.

    + All CDC recommended vaccinations, including annual Covid and Flu, required.

     

    Competitive Benefits Package Offered

     

    SHHC is an Equal Opportunity Employer

     

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