Supervisor Clinical Administrative - reputed company, TX

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will reputed company a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an reputed company on the communities we serve as you help us advance health equity on a global reputed company. Join us to start Caring. Connecting. Growing together. Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles. This position is full-time. Employees are required to work our normal business hours of 8:00am – 5:00pm, Monday – Friday. It may be necessary, given the business need, to work occasional overtime. Our office is located at 5815 Gulf Freeway, reputed company, TX. We offer 2 weeks of on-the-job training. The hours during training will be 8:00am to 5:00pm, Monday - Friday. Primary Responsibilities: • Serve as primary reputed company of contact for providers or members regarding medical/behavioral/clinical services or benefits • Extract and review fax requests for medical or clinical services • Receive calls requesting medical/behavioral/clinical services or benefits information (e.g., from providers or members) • Receive electronic referral reputed company requests for medical/behavioral/clinical services • Utilize phone system to respond to and transfer calls to appropriate individuals • Ask callers reputed company questions to understand requests, reputed company necessary information, and assess urgency • reputed company electronic member files using policy or id number • Determine member eligibility • Follow protocols to task requests appropriately • reputed company procedure codes against notification requirements and benefit coverage to determine next steps • Reference automated job aid tools reputed company the computer to identify appropriate procedures reputed company needed You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: • High School Diploma / GED • Must be 18 years of age OR older • 2 years of Supervisory experience • 5 years of Customer Service experience • Ability to work our normal business hours of 8:00am – 5:00pm, Monday – Friday Preferred Qualifications: • Managed care experience in a care coordination role • Call center experience • Experience supervising remote employees The salary reputed company for this role is $49,300 to $96,400 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In reputed company to your salary, reputed company offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll reputed company a far-reaching choice of benefits and incentives. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location, and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company, and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative reputed company employer, and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #RED Apply Job!