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Job Field: Legal Jobs
Location: San Diego, CA
Salary: $Depending on experience

JOB SUMMARY:

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<tr><td valign="top" width="450"><b>DESCRIPTION/RESPONSIBILITIES
Job Summary
Responsible for providing data entry and administrative support to the CMC team while ensuring sensitive information is safeguarded, complete, accurate, and transferred in a timely manner for smooth operational flow.
Essential Functions
* Accountable for accurate data entry within established time frame that consistently meets or exceeds performance levels i.e., treatment plans, case set-up, provider dispositions, core indicator, EAP payments etc.. Review information for completeness and accuracy that consistently meets or exceeds performance levels i.e., filtering, treatment plans, medical records etc.. Keep log of daily productivity i.e. time tracking system, task list, tick sheet etc..
* Coordinate administrative/clinical appeals, retrospective and Physician Advisor reviews. Request and track necessary information to ensure compliance is within turn-around-time standards. Provide support with out-of-network provider agreements. Update member/provider demographics in systems when notified of changes.
* Monitor and respond to messages left on voice mail/audix that consistently meets or exceeds performance levels i.e., provider inquiry calls, authorization extensions, problem resolution etc.. Coordinate Customers Comments and forward required information to appropriate staff that consistently meets or exceeds performance levels. Provide administrative support to front-line CSAs.
* Assume responsibility for self-development and career progression. Proactively seek and participate in ongoing training formal and informal in all aspects of the Support Specialist role. Mentor and train of new Support Specialists. Remain responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers.
Non-Essential Functions
Other duties/projects as assigned
The duties and responsibilities listed above are representative of the nature and level of work assigned and are not necessarily all-inclusive. Specific references to behavioral healthcare duites are not applicable to all Support Specialists including, but not limited to those working in the Radiology industry.
Service Delivery Expectations
One must be customer service oriented, meet Magellans Servicestandards in all categories consistently, team player, maintain member and provider confidentiality at all times, demonstrate effective
problem solving skills, and be punctual and maintain good attendance.
REQUIRED SKILLS
*Minimum Requirements
*Education HS/GED
*Experience Job growth will be based on demonstrated competence at performing this role.
Computer Skills Excellent computer, data entry and typing
skills Knowledgeable of Microsoft 97 Word and Excel.Must be proficient typist and able to maneuver through various computer platforms while verifying demographic information.

KEY REQUIREMENTS:

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No High School/GED