Administrative Support

Title: Administrative Support

Duration: 3+ Months (Possible extension)

Location: Philadelphia, PA

Responsibilities:

· Under the direction of the Manager, Clinical Outcomes & Therapeutic Optimization (COTO) the COTO Coordinator will be responsible for supporting administrative functions as well as non-clinical tasks within the COTO department for both Medicare and non-Medicare clients.

· Monitors phone queue and answer calls generated by members/providers. Forward higher complexity and/or clinical member/provider inquiries to COTO pharmacist or COTO Department Manager as appropriate.

· Provides knowledgeable and courteous member/provider customer assistance in regards to COTO Department programs and pilots.

· Acts as the primary resource for outbound call needs including but not limited to: demographic updates, refill reminder updates, scheduling of patient consultations and various member/provider outreach campaigns.

· Performs and documents general member history assessment utilizing the department’s documentation platform; records patient comments and inquiries; and review and update member demographics.

· Faxes or mails interactive consultations to members and providers which have been completed by clinical staff. Ensures tasks are completed in a timely manner.

· Reviews returned mailed, making appropriate updates, documenting information according to department policies and procedures and resolving issues when necessary.

· Proficient in use of claims processing system, JIVA and PerformPRO, including: ability to document in both systems utilizing established workflow processes, send letters to members and providers through PerformPRO, and complete items in task queue for all COTO Department programs.

· Assigns interactive consultation requests to clinical staff for member calls generated through queue. Ensures DTM task queue is up-to-date and technician tasks are completed within a timely manner.

· Follows established process workflows for inbound/outbound calls generated within department.

· Administratively supports the COTO Area. Performs varied administrative duties inclusive of handling correspondence, maintaining calendars and mailboxes,

· Reports issues with PerformPRO application to COTO Department Manager and/or Analysts.

· Forwards member inquiries outside scope of COTO to appropriate resource utilizing call tree.

· Comply with CMS & URAC MTM/DTM Standards.

· Performs other job related duties and projects as assigned.

Kind Regards

Sumit Agarwal

732-902-2125