Clinical Operations Representative - Task Force at TurningPoint Healthcare

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Full Time

Start Date

Immediate

Expiry Date

09 Oct, 26

Salary

0.0

Posted On

11 Jul, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Customer Service, Healthcare Operations, Data Entry, Microsoft Word, Microsoft Excel, Microsoft Outlook, Problem Solving, Multitasking, HIPAA Compliance, Medical Case Processing, Phone Queue Management, Organizational Skills

Industry

Hospitals and Health Care

Description

Clinical Operations Representative - Task Force Shift Hours: 9:00am- 5:30pm Who We Are: TurningPoint Healthcare Solutions is a leader in advanced clinical and technology-enabled complex condition management. TurningPoint provides an innovative suite of specialty care management services and technologies that enable health plans and employers to improve the safety, quality, and affordability of healthcare. Through its platform and specialized team of clinical experts, TurningPoint works collaboratively with providers to deliver optimal care. TurningPoint offers condition-specific, quality-driven, value-based care management services that optimize care from diagnosis and discovery through recovery. TurningPoint’s comprehensive and integrated suite of services enhances the support individuals need, at the time they need it most. Since launching in 2015, TurningPoint has provided support to more than 50 million people nationwide across numerous clinical specialties including musculoskeletal, pain management, cardiology, wound care, ear/nose/throat, and sleep. TurningPoint’s model moves beyond denial-based care to holistic condition management that improves outcomes and reduces cost. TurningPoint is an independent organization, not owned or affiliated with a health plan or provider system. Position Summary: As a Clinical Operations Representative you will assist in daily activities servicing customers including doctor's offices and patients. This will include processing requests received via telephone, fax, and e-mail and providing or validating request information. This position supports the Utilization Review Nurses in creation of the medical cases. The ideal candidate will have great attention to detail and advanced grammar and punctuation skills. This position is full-time with variable shifts. Responsibilities: * Responds to customer questions via telephone and written correspondence regarding medical cases. * Thoroughly documents inquiry outcomes for accurate tracking and analysis. * Develops and maintains positive customer relations and coordinates with various functions within the * company to ensure customer requests and questions are handled appropriately and in a timely manner. * Responsible for meeting or exceeding quality and productivity expectations to ensure customer satisfaction. * Review and maintain service requests and call center database for completeness of information * Handles most complex calls with minimal assistance. Provides assistance in and/or refers high-level, complex * questions, problems or client complaints to appropriate resources to ensure customer satisfaction * Enters updates to pertinent insurance data from Document Management System or FAX into the computer * system in a timely manner ensuring accuracy, completeness, and adherence to department procedures * Perform outbound calls to members, providers, and clients * Respects and maintains HIPAA confidentiality guidelines * Other duties as directed Qualifications: * Minimum of 3 years’ experience in customer service, or healthcare operations; Required * Associates Degree in a business or health related field is; Preferred * Demonstrates dependability by following instructions, policies, and procedures; exceeds productivity * standards, meets deadlines, and adheres to work schedules * Strong problem solving and troubleshooting skills with precise attention to detail * Phone queue experience and data entry skills, Preferred * Intermediate to advance proficiency in Microsoft Word, Excel and Outlook * Strong organizational skills and ability to multitask * Medical Assistant Certification, a plus! TurningPoint Healthcare Solutions is an Equal Opportunity Employer.

Responsibilities

The role involves assisting customers, providers, and patients by processing medical case requests via phone, fax, and email. It also includes documenting inquiries and updating insurance data to support Utilization Review Nurses.