Clinical Services Coordinator, Advanced

Your Role

The Facility Compliance Review (FCR) team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions.. The Clinical Services Coordinator, Advanced will report to the Manager, Operations FCR. In this role you will assist the clinical team to ensure a timely review of facility compliance claims, including monitoring queues, assisting with administrative support to the FCR team This will include management of daily inventory, assisting with researching claims, pulling medical records and answering questions sent to the FCR mailbox. The main goal of this team is to support the clinical team to ensure they have what they need in order to complete the medical necessity reviews.

Your Knowledge and Experience

• Requires a high school diploma or equivalent
• Requires at least 5 years of prior relevant experience
• Requires health insurance/managed care experience
• Requires strong computer navigation skills
• Requires independent motivation and strong work ethic