Description

1. Maintains relationship with payors to ensure data accuracy for closure process.
2. Maintains internal closure log for all sites to ensure a successful closure process.
3. Tracks requested, follow up attempts and receipt of medical information from Primary Care Physicians.
4. Prepares, tracks, and maintains reports to provide pertinent data, using indicated documentation.
5. Verifies data report accuracy and integrity and upholds confidentiality of protected health care information.
6. Assists in reconnecting members with services who have not had outreach for an extended period of time.
7. Complete and updates appropriate clinical documentation to ensure an updated record.
8. Schedules and links members to appropriate appointments and future services within the organization.
9. Coordinates with IS on design, development, and execution of complex queries to pull data from CODAC systems.
10. Coordinate project based work.
11. Communicates with stakeholders, members, and participants, staff, and the public in a manner that reflects positively on the agency.
12. Works with all levels of internal staff to address system discrepancies.
13. Assists in all aspects of roster reconciliation for members pending closure.
14. Returns all inquiry calls within 24 hours excluding weekends and holidays.
15. Performs other related duties in accordance with agency growth and changes.

Qualifications

• Masters or Bachelors degree in a healthcare field and no related experience OR;
• Masters or Bachelors degree in a non-healthcare related field and 3 months relevant related experience OR;
• Associate degree in a healthcare field and 6 months related experience OR;
• Associate degree in a non-healthcare field and 1 years related experience OR;
• Certified Medical Assistant and 1 year related experience
• Certified Peer Support Specialist and 1 year related experience OR;
• High School diploma or General Education Equivalent (GED) and 2 years related experience.

• Commission Certified Care Manager (CCCM), a plus.

1. Valid Arizona Drivers license, proof of current insurance and willingness to use personal vehicle.
2. Clean Motor Vehicle Record - no more than 2 moving violations or a license suspension in past 3 years.
3. Interest and commitment to helping members in crisis from varied social economic backgrounds

1. Bilingual skills a plus.
2. Knowledge of principles and processes for providing excellent customer service.
3. Understanding of Intake and Financial Eligibility paperwork, and Arizona Department of Behavioral Health and payor/ Intake policies and procedures.
4. Familiarity with a variety of computer software used for researching, tracking, data entry/processing, and reporting information, i.e. AHCCCS, Excel, Word, and various statistical or graphics programs.
5. Diagnosis or clinical documentation knowledge
6. Knowledge of medical records standards and current statutes pertaining to member medical records.
7. Knowledge of benefits eligibility standards and processes.
8. Knowledge of administrative/clerical procedures and office equipment.
9. Ability to assess and resolve complex aspects of members.
10. Ability to evaluate facts or situations to determine appropriate action.
11. Ability to follow written and oral instructions, and to communicate effectively both orally and in writing.
12. Ability to establish and maintain effective working relationships with staff, providers, members, funding sources and other agencies.
13. Ability to maintain confidentiality and comply with HIPAA standards.
14. Familiarity with various diverse ethnic and cultural groups.