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Clinical Services Coordinator

Company: Paradigm
Location: Lombard
Posted on: March 25, 2020

Job Description:

Description: SUMMARY:This position holds accountability for the successful administrative partnership with the Director of Clinical Services (DCS) and the Network Manager (NWM) in the overall management of contracts. This includes tracking of all customer deliverables that meet targeted timelines and reflect and support patient management, facilitation of patient management team communication and general support of both the Network Manager and the Director of Clinical Services to ensure proactive and well-conceived management plans. In addition, the Clinical Services Coordinator holds an administrative accountability, in partnership with Network Services, to designated Network Business Owners (or designees) to reinforce their full understanding and support of Paradigm process and direction.ESSENTIAL RESPONSIBILITIES include the following. Other work-related duties may be assigned.Partner with Director of Clinical Services to manage the development of all new contracts, including participation in clinical conferences, tracking of appropriate documents and development of budget and financials associated with the contract.Participate and /or facilitate and document results of all patient related conferences as requested by the Director of Clinical Services.Research and document patient driven costs and provider rates that drive budget development and management. Utilize web driven and other electronic resources to identify potential costs, including use of CPT codes in the companys electronic claims adjudication system.Ensure smooth administrative management of all assigned Paradigm cases, including tracking and routing of patient reimbursement requests, PRNs, PNFs and PCA requests.Track all customer deliverables to ensure timely submission that meet company Standards of Performance. Initiate appropriate action plans for late reports or plans/contracts.Provide instruction to the administrative team regarding the entry of accurate patient demographic data in the electronic data collection system.Participate in the report review process as required by established workflow procedures.Serve as primary point of administrative contact for case specific Network Manager, including providing information and direction regarding deliverable timelines, authorization of services, budget and provider management, as well as appropriately managing and directing case specific requests and inquiries from the Network Manager, patient/family or provider.Liaison with assigned administrative Network Business contacts, providing education regarding Paradigm internal process, product revision or implementation and specific Network Manager performance issues.Collaborate with other internal departments (Contracting, Claims, Accounting) to address and resolve specific patient / provider issues.Participate in procedural and workflow development for the CSC team as well as the overall Clinical Management team.Responsible for complying with Paradigm IT security requirement and policies.Responsible for safeguarding Paradigm or Paradigm related IT passwords.Responsible for notifying Paradigm of any IT security incidents per Policy No. 16 Information Security Incident Management.ProjectsParticipate in company projects requiring CSC representation, as requested by management.CSC Expectations/Team ResponsibilitiesThe case load is equitably distributed among all CSCs.All CSCs will participate in the creation of and adopt CSC best practices.The CSC team will assist with training of new CSCs and education of various other team members as assigned by manager.The CSC team is expected to provide backup coverage for each other as requested by the manager.PM19. Requirements: QUALIFICATION REQUIREMENTS: To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Education - Bachelors degree from an accredited educational institution preferred.Experience - Three to five years progressively responsible customer service experience. Three years related experience in provider relations or health care. Strong medical background to include comprehensive understanding of medical terminology and health care principles and practices. Demonstrated ability to multi-task in a fast paced work environment. Experience with various computer applications including Microsoft Office, Outlook, WORD and Excel.Language - Excellent oral communication skills and phone presence. Ability to read and comprehend instructions, correspondence, memos, and medical/patient reports. Ability to write correspondence and memos and utilize e-mail communication effectively. Ability to present information in one-on-one and small group situations.Reasoning Ability - Excellent analytical skills -- ability to define problems, collect data, establish facts, and draw valid conclusions; ability to interpret a variety of instructions and deal with abstract and concrete variables; demonstrated ability to analyze difficult situations, problems, and data; use good judgment and decision making.Any combination of education/experience and knowledge that demonstrates the ability to perform the functions of the position will be accepted.PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Physical Activities: While performing the duties of this job, the employee is regularly required to reach with hands and arms, and to talk or hear. The employee is frequently required to sit. The employee is occasionally required to stand and walk.Weight Lifted/Force Exerted: The employee's job does not require weight to be lifted or force exerted.Vision Requirements: Specific vision abilities required by this job include close vision and the ability to adjust focus.WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Environmental Conditions: While performing the duties of this job, the employee does not: work in wet or humid conditions (non-weather); work near moving mechanical parts; work in high, precarious places; endure outdoor weather conditions; endure extreme cold or heat (non-weather); or is at risk of electrical shock.Noise Level: The noise level in the employee's work environment is usually quiet to moderate.PI119043197PandoLogic. Keywords: Clinical Services Coordinator, Location: Lombard, IL - 60148

Keywords: Paradigm, Lombard , Clinical Services Coordinator, Healthcare , Lombard, Illinois

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