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Clinical Claims Care Coordinator (RN or LSW required)

illumifin -
Remote

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Job Details

Full-time
From $60,000 a year
10 days ago

Benefits

Wellness program
Health savings account
Disability insurance
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Parental leave
Employee assistance program
Vision insurance
401(k) matching
Employee discount
Life insurance
Referral program
Paid sick time

Qualifications

Customer communication
RN License
Social work
HIPAA
Working with geriatric patients
Database management
Typing
Productivity software
Geriatrics

Full Job Description

WE ARE THE KIND OF EMPLOYER YOU DESERVE.

illumifin is an insurance technology company and third-party administrator that designs, develops and delivers tech-enabled insurance policy management software and services that provide unrivaled value for insurers.

We combine insurance insight, operational excellence, and technology innovation to build solutions that deliver high performance and position insurers for the digital world. illumifin is primarily focused on the North American life, long-term care, annuity, and health markets. We believe in true partnerships with our customers and are passionate about insurance.

The Clinical Claims Care Coordinator reviews the assessment that is completed by the field assessor for completeness, accuracy and ensures that the assessment provides the insurance carrier with a clear picture of the policyholder’s current functioning. They also obtain clarifying information from the field assessor and provides guidance to that assessor on the correct completion of the interview tool. A Clinical Claims Care Coordinator will create a plan of care and be required to review and certify for chronic illness.

CLINICAL CLAIMS CARE COORDINATOR RESPONSIBILITIES

Review onsite assessments for consistency and quality and collaborates with the field nurse.
Obtain information from the field assessor to clarify information and provide the carrier with a thorough, high quality assessment product.
Prepare professional, objective report for the insurance customer summarizing information from the assessment using company formats, when appropriate.
Manages the clinical quality review for the completed assessments.
Act with independent judgement following client and company policies and procedures.
Complete telephonic and virtual interviews as need arises.
Always provides prompt, courteous and excellent customer service to internal and external customers.
Demonstrate effective communication skills, level of attentiveness and use of appropriate lines of authority. Promptly shares accurate and complete information to others who need it, based on HIPAA and legal documents regarding release.
Attend or is responsible for information given at meetings and through other organizational channels.
Meet established quality and production expectations as established and communicated by the department.

CLINICAL CLAIMS CARE COORDINATOR REQUIREMENTS

Registered Nurse: Two years of geriatric experience
Licensed Social Worker: Two years geriatric social work experience
Must type at least 40 words per minute.
Intermediate level experience with Microsoft Office products.
Database experience.

The annual compensation range starts at $60,000 but can increase depending on experience and qualifications

illumifin is an Equal Opportunity Employer (EOE/AA) and participates in E-Verify. illumifin will not discriminate in its employment and employment-related decisions against any applicant or employee based on age, race, gender, creed, religion, national origin, disability, marital status, covered veteran status, sexual orientation, status with respect to public assistance, membership or activity on a local commission, or any other characteristic protected under state, federal, or local law.

Benefits:

401(k)
401(k) matching
Dental insurance
Disability insurance
Employee assistance program
Employee discount
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid sick time
Paid time off
Parental leave
Referral program
Vision insurance
Wellness program

Experience:

Assessments: 2 years (Preferred)

License/Certification:

RN License (Preferred)
LSW (Preferred)

Work Location: Remote

Quick Apply

Refine Your Search

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MDS Coordinator (Float)

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Admission - MDS Coordinator (RN)

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