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Clinical Claims Care Coordinator II - RN or LSW
Clinical Claims Care Coordinator II - RN or LSW-April 2024
Remote
Apr 1, 2026
About Clinical Claims Care Coordinator II - RN or LSW

  Review onsite assessments for consistency and quality and collaborates with the field nurse. * Obtain information from the field assessor to clarify information and provide the carrier with a thorough, high quality assessment product. * Prepare professional, objective report for the insurance customer summarizing information from the assessment using company formats, when appropriate. * Manages the clinical quality review for the completed assessments. * Act with independent judgement following client and company policies and procedures. * Complete telephonic and virtual interviews as need arises. * Always provides prompt, courteous and excellent customer service to internal and external customers. * Demonstrate effective communication skills, level of attentiveness and use of appropriate lines of authority. Promptly shares accurate and complete information to others who need it, based on HIPAA and legal documents regarding release. * Perform work accurately and demonstrate ability to prioritize workload. * Use supplies and other resources (i.e. equipment, computer systems, tools, energy, etc.) efficiently and effectively. * Attend or is responsible for information given at meetings and through other organizational channels. * Uphold the principles of compliance as outlined in the Code of Conduct, Employee Handbook and related policies and procedures. Supports and participates in the mandatory Corporate Compliance Program training initiative on an annual or more frequent basis, as required. * Meet established quality and production expectations as established and communicated by the department. * Other duties as assigned. * Registered Nurse: Two years of geriatric experience or * Licensed Social Worker: Two years geriatric social work experience * Must type at least 40 words per minute. * Intermediate level experience with Microsoft Office products. * Database experience. Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

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