Join Blue Shield of California as a Clinical Services Coordinator, Advanced, where you'll support the FCR team in ensuring compliance with facility claims and medical necessity reviews. Your role will involve processing requests, monitoring workflows, and providing essential administrative support to enhance the clinical team's efficiency.
Key Responsibilities
Process authorizations and UM/CM requests
Monitor queues/workstreams and generate reports
Handle customer/provider calls
Check member history and research eligibility
Assign initial EOA days or triage to nurses
Assist with medical records and data entry
Provide administrative support to the FCR team
Act as a liaison for care management programs
Work on projects with Operations Specialist and Senior Manager