About the position Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Alignment Health is seeking an compassionate, customer service oriented, and organized, bilingual Spanish care coordinator in California to join the remote Care Anywhere team. The Care Coordinator is responsible for supporting the Care Anywhere Program field providers, scheduling, outreach, and managing all care coordination needs for high-risk members enrolled with the program. If you're looking for an opportunity to learn and grow, be part of a collaborative team, and make a difference in the lives of seniors - we're looking for YOU! Individuals with front office medical assistant experience, experience supporting multiple providers, and high call volume experience are highly encouraged to apply. Schedule: Mondays - Fridays - Option 1: 8:00 AM - 5:00 PM Pacific Time (with 1-hour lunch) - Option 2: 8:30 AM - 5:30 PM Pacific Time (with a 30- minute lunch)

Responsibilities

• Manage (4) provider schedules to ensure schedules are filled.
• Prepare charts for upcoming home visit appointments (check member eligibility, gather records needed by the provider prior to the home visit)
• Conduct outreach for scheduling, appointment confirmation calls, wellness checks for high risk members, and to providers / pharmacies for member needs.
• Handle inbound / outbound Call (60 - 80 calls / day)
• Obtain medical records from provider offices, hospitals and skilled nursing facilities (SNF) and upload medical records to the electronic medical records (EMR).
• Submit referral authorizations to independent physician association (IPA) / medical groups for specialty, durable medical equipment (DME), and home health (HH) services.
• Coordinate lab orders, transportation for high-risk members.
• Documentation via EMR for Inbound / Outbound calls.
• Support short message service (SMS) and member outreach campaigns.
• Assist nurse practitioner (NP) team with visit preparation needs
• Appointment reminders to members
• Assign members to NP in EHR
• Provide needed documentation to NP for visits each day
• Direct inbound calls from members / family related to medication refills
• Assist with maintaining and updating members' records
• Assist with mailing or faxing correspondence to primary care physicians (PCP), specialists, related to, as needed.
• Attend Care Anywhere meetings / presentations and participates, as appropriate.
• Recognize work-related problems and contributes to solutions.
• Work with outside vendors to provide appropriate care needs for members

Requirements

• Required: Minimum (1) year experience entering referrals and prior authorizations in a healthcare setting.
• Required: High School Diploma or GED.
• Required: Able to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
• Knowledge of ICD9 and CPT codes
• Knowledge of Managed Care Plans
• Able to type by 10-key touch minimum of 40 words per minute (WPM)
• Proficient with Microsoft Outlook, Excel, Word
• Effective written and verbal communication skills; able to establish and maintain a constructive relationship with diverse members, management, employees and vendors;
• Able to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals.
• Able to write routine reports and correspondence.
• Communicates effectively using good customer relations skills.
• Able to add and subtract two-digit numbers and to multiply and divide with 10’s and 100’s. Able to perform these operations using units of American money and weight measurement, volume, and distance.
• Able to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Able to deal with problems involving a few concrete variables in standardized situations.
• Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
• Bilingual English / Spanish required.
• None
• 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.

Nice-to-haves

• Preferred: 2 years' healthcare experience.
• Preferred: Completion of medical assistant program from an accredited school of training
• Preferred: Medical Terminology
• Preferred: Knowledge working in Athena
• Preferred: Medical assistant certificate
• Medical terminology certificate