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Medical Access Assistant in Newport Beach at One Call

Date: 8/10/2018

Job Snapshot

Job Description

Medical Access Assistant

Harbor Health Systems is a Center of Innovation for One Call Care Management. Our primary focus is the development and advancement of new products and solutions related to improving workers compensation outcomes by focusing on maximizing the use of quality providers and streamlining the process of coordinating care for injured workers. Our directive is to be disruptive innovators in the workers compensation managed care space with a primary focus on changing how care is accessed and managed. Under the supervision of the Manager MPN Concierge Services, the MPN Concierge Agent is responsible for various activities related to providing injured workers, attorneys, employers, and /or claims examiners with assistance identifying and /or obtaining MPN physicians for the injured workers.  Excellent customer service and patient advocacy is a fundamental attribute to performing this job.
  • Answering inbound and outbound phone calls from injured workers and/or their applicant attorneys who are trying to locate an available provider within their MPN for treatment.
  • Responding to emails and faxes related to medical access assistant (MAA) activities.
  • Contacting providers' offices for scheduling appointments on behalf of the injured worker.
  • Interfacing with Claims Examiners to facilitate the scheduling of doctor appointments.
  • Contacting injured workers or their applicant attorneys to direct them to MPN providers.
  • The MPN Concierge Agent will also provide support to Harbor Health Systems' Network Operations Team e.g. conducting provider validations, assist with the maintenance all provider contracts templates and provider data.
Knowledge, Skills and Abilities:
  • Successfully complete call center training.
  • Ability to learn new, detail oriented skills in a short amount of time
  • Adeptness in utilizing all required systems/applications.
  • Ability to prioritize responsibilities and multitask throughout the day
  • Pleasant and professional phone demeanor while managing incoming and outgoing telephone calls
  • Assist caller with locating network physicians and facilities, scheduling appointments, and answering general questions related to MPNs
  • Communicate with insurance carries, claims examiners, attorneys, and providers in a professional manner
  • Coordinate the scheduling of services within One Call Care Management's various business units
  • Manage detail related processes with better than average accuracy
  • Ensure client expectations are met or exceeded in a quality manner and on a timely basis
  • Ability to be flexible in handling changing priorities and work processes
  • Perform other duties as requested or assigned
Experience/Education:
  • High School diploma/ GED required
  • Strong written and verbal communications skill required
  • Computer literacy and experience with Microsoft Office is required
  • Type at least 50 wpm with 85 % accuracy required
  • Knowledge of medical terminology preferred
  • Previous call center or customer service experience preferred
  • Previous experience in a California Worker's Compensation Managed Care Insurance, Claims and/or review, claim, medical billing, intake coordinator, etc.) preferred
  • Bilingual English/ Spanish preferred
Hours of operation Monday- Friday 7 am- 8 pm and potentially some Saturdays

Physical/Emotional Demands and Work Environments: 

  • For roles located in office or home settings; this job is primarily sedentary and may involve repetitive motions; the employee is regularly required to sit, use hands and fingers, speak, and hear
  • For roles located in the field; this job is primarily active; the employee is regularly mobile and must be able to utilize transportation (such as driving), sit, use hands and fingers, speak, and hear
  • The employee is occasionally required to stand, walk, and lift objects (up to 10lbs weight; up to 4 ft. height). 
  • Specific vision abilities required by this job include ability to see things from a close distance and ability to adjust focus
  • The work environment utilizes florescent lighting; noise level is moderate
  • The emotional demand of the job may cause undue stress from, but not limited to, moderate/heavy workload
  • Reasonable accommodations will be individually assessed and possibly made to enable individuals with disabilities to perform the essential functions of the position. 
  • Please be advised the job description is subject to change at any time