Job Description

Clerical Assistant

JOB-10043793

Anticipated Start Date

May 19, 2025

Location

Bronx, NY

Type of Employment

Contract Hire

Employer Info

Our client provides top-ranked care, dozens of inpatient and outpatient specialties, and mental health services with a team of highly trained and caring medical professionals who are compassionate, culturally competent and patient centered. Their vision is to be a fully integrated health system that enables New Yorkers to live their healthiest lives. Many of their roles are temp-to-hire, giving our client and our candidates the opportunity to ensure they are the right fit for a full-time position, as this comes with career advancement opportunities and excellent benefits. In fact, over 30% of our candidates have converted to full time positions at our client.

Job Summary

We are looking for individual to join our client’s team as Clerical Assistant. You will provide an understanding of the positions that were assigned to the Managed Care department and each function under each title. By providing a specific as well a general description of the work, skills, and developments of skills if needed to properly run the Managed Care Department tasks.

Job Description

• Assist the Managed Care team in the provider payer enrollment.
• Assist members in the dis-enrollment process.
• Assist the members with the change of Primary Care Provider in their contracted plans.
• Assist the member with the change in Dental services site/location practice.
• Assist the Managed Care team in the outreach process of the non-user member in a collaborative effort with the practices.
• Assist the Finance Prior Authorization- team in the coordination of services for the members.
• Assist Lincoln in the achievement of the goals and standards of care based on the: CMS, NCQA, PSI, the Joint Commission, Leap Frog Grades, etc.
•   Performs other duties as assigned by supervisor.

Skills Required

• High standards and values in professional ethics such as honesty, professionalism, and integrity.
• Understanding of high efficiency of Microsoft 360 Office: Word, Excel, PowerPoint, PDF docs, Outlook/ Webmail, etc.
• Possess high proficiency of analytical skills.
• Effective communicative skills; verbal, writing, and public speaking. Needs to be able to communicate with different stakeholders such as; leadership, providers, payers/representatives, patients, State regulators, and colleagues.
• Understanding the Managed Care concept and the programs and the finance business that represent to Lincoln Medical Center.
• Understanding on Healthcare Management, Public Administration, Public Health, Utilization Management, Return of Investment concept, Value-Based concepts, Medicare Programs, Medicaid benefits, and programs.
• Understanding of concepts and vocabulary such as; members, payer, capitation, reimbursement, care gaps, health inequality, withholding treatment, payers contract, contracted services, Participant, Non-Par payers, NPI, Licenses, NEW York regulation, Standards of Care, Medical Necessity, etc.
• Payer's portals: Anthem, United Healthcare, Healthfirst, Emblem, Metroplus, ADA, Wellcare, etc.

Education/Training/Certifications

• Minimum Degree Required: Completed High School (Diploma or GED)

Additional Requirements

• Schedule Notes 9am-5pm Monday-Friday

Pay Rate

• $25.00 per hour

“We are an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status or other characteristics protected by law”.

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