Clinical Support Coordinator

Squirrel Hill Health Center (SHHC), is a Federally Qualified Health Center (FQHC), seeking a dedicated Clinical Support Coordinator to join our team. ​The ideal candidate will ensure that healthcare services, medications, or treatments are approved by insurance providers before they are administered. ​This role involves acting as a liaison between patients, healthcare providers, and insurance companies to streamline the authorization process.

The Clinical Support Coordinator will assist SHHC Providers in managing and maintaining electronic or paper-based forms to ensure accurate and complete data collection and documentation. ​This position requires prompt, courteous, professional, and accurate interactions with SHHC patients to ensure the smooth flow of both people and information through the SHHC system. ​The role involves working in-office, with the ability to travel to other locations for coverage as directed. ​

Responsibilities: ​

• Authorization Management: ​
  • Submit and follow up on prior authorization requests for medications, procedures, or treatments. ​
  • Communicate with insurance companies to ensure timely processing of authorizations. ​
  • Verify patients' insurance coverage and benefits for specific services. ​
• Coordination: ​
  • Collaborate with healthcare providers to gather necessary documentation and clinical information. ​
  • Act as a liaison between patients, healthcare providers, and insurance companies. ​
  • Notify providers and patients of approval or denial statuses, including next steps for appeals if necessary. ​
• Documentation: ​
  • Accurately document all communication, actions, and decisions related to prior authorizations and Provider forms distribution. ​
  • Maintain compliance with HIPAA and other healthcare regulations. ​
• Problem Resolution: ​
  • Resolve authorization delays or denials by communicating with insurance representatives. ​
  • Analyze denial reasons and recommend appropriate follow-up actions. ​
• Customer Service: ​
  • Provide clear and empathetic communication to patients regarding insurance requirements. ​
  • Educate providers and staff about payer requirements and updates. ​
  • Act as a liaison between patients, physicians/NPs/PAs, and other entities regarding Clinical Operations and patient needs. ​
  • Obtain release of information to seek necessary records and ensure proper review and follow-up with physicians/NPs/PAs. ​
• Other Duties: ​
  • Ensure forms comply with company, industry, or regulatory standards. ​
  • Accurately, promptly, and consistently document all patient interactions in the Electronic Health Record. ​
  • Maintain confidentiality and compliance with HIPAA. ​
  • Refer patients to the Care Navigation Team for necessary social services. ​
  • Coordinate clinics and other offsite prevention services as directed by SHHC Management. ​
  • Perform other duties as directed. ​

Qualifications: ​

• High school diploma or GED required; associate’s degree or healthcare-related certification preferred. ​
• 1-3 years of experience in a healthcare setting, insurance verification, or prior authorization. ​
• Knowledge of medical terminology, ICD-10, and CPT coding. ​
• Proficiency in using healthcare software systems and ability to learn new systems. ​
• Strong computer skills, including proficiency in EHR, Microsoft Word, Teams, Outlook, and Excel. ​
• Ability to assess, understand, and react effectively to the unique needs of various patient populations served. ​
• Excellent critical thinking, organizational, interpersonal, and communication skills. ​
• Attention to detail for design accuracy and compliance. ​
• Professional and effective communication with a wide range of clients in person and by telephone or Portal. ​
• Ability to manage work efficiently and consistently. ​
• Fluency in a second language is preferred. ​
• Must be able to work in any SHHC location onsite or remotely as needed. ​
• Must accommodate occasional schedule changes to provide patient care. ​
• CPR certification preferred but not necessary. ​
• Commitment to serving populations consistent with SHHC’s mission.
• All CDC recommended vaccinations, including annual Covid and Flu, required.