Service Coordination AssociatePrimary Location: Topeka, KS
Additional Locations: KS-Topeka Apply
- Make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan.
- Utilizes Aetna systems to build, research and enter member information, as needed.
- Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g.,health care providers, and health care team members respectively)
- Provides support services to team members by answering telephone calls, taking messages, researching information and assisting in solving problems.
- Adheres to Compliance with PM Policies and Regulatory Standards.
- Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
- Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
- Supports the administration of the case management and quality management processes in compliance with various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA) standards where applicable, while adhering to company policy and procedures.
- 2-4 years experience as a medical assistant, office assistant, in a MCO or clerical/assistant position.
- High School Diploma or G.E.D.
- Effective communication, telephonic and organization skills.
- Familiarity with basic medical terminology and concepts used in care management.
- Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.
- Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word.
- Ability to effectively participate in a multi-disciplinary team including internal and external participants.
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