The Non-Clinical Support Manager will lead and manage a dedicated team that provides essential non-clinical support to the Medical Management and Operations departments. This role is responsible for ensuring that all processes and operations comply with the regulatory requirements of various health plans, including Medicare, Medicaid, and commercial insurance products. The Non-Clinical Support Manager will also oversee the creation, enforcement, and optimization of business processes to align with health plan requirements, contributing to the overall success of the organization’s compliance efforts and operational efficiency. Additionally, this position is accountable for ensuring that clinical information is accurately gathered and processed within set turn-around times (TATs), ensuring quality service delivery and adherence to regulatory standards.

The Retail Sales and Customer Service Associate plays a key role in ensuring excellent customer service, managing sales transactions, and maintaining a well-organized sales floor. This position is responsible for completing sales transactions and returns efficiently, while ensuring the enforcement of return policy limitations and restrictions. The associate also manages the front end of the store by performing daily inventory checks and replenishing stock to fill any gaps on the sales floor. In this role, the associate attends to customer inquiries by assisting with product searches, both in-store and online, to ensure a positive shopping experience. Additionally, this role includes monitoring local and internal security alerts to safeguard the store’s assets and enforcing quality control policies and procedures to reduce and prevent theft.

Responsible for productivity and facilitating the success of 32 team members. Coaching and training staff to build a strong foundation for my team.Mentor coordinator – responsible for maintaining balancing team of 12 mentors and coordinating all new hire classes. Educating and guiding associated with tough obstacles they may face with training. Available to provide tips and solutions for a successful new-hire class, including but not limited to referral specialists, newly onboarded team leads.Sleep coordinator – responsible for the queue upkeep for all plans associated with modality. Addressing issues and coordinating workgroup solutionsProxy for Genetics and MSK emails – coordinating and troubleshooting functionality of solutions. Providing guidance to staff with workaround resolutions.Trained during the first wave of group during the Genetics, MSK, and Rehab Modality role outs.PTO proxyAppeal submission coordinator – coordinating with fellow team lead colleagues in the timely submission for audit appeals, allowing enough time to review submissions, and go back to associates for clarity on submissions if required to assure effective resolutions. Data collected is then presented at the monthly appeals meeting alongside auditors and management.Working with ASM to rectify issues regarding unclosed cases to determine root cause to avoid repeat occurrences.

Answer incoming call and process pre authorization request while exhibiting exceptional customer service skillsMaintain knowledge with health plan policies and AIM processes for appropriate authorization productivity.Follow up with providers office when needed for case resolution.Problem solve to de-escalate clients who call in with issues regarding patient cases.Apparent of the mentor group for incoming classes of new-hires

Attend to customer inquiries pertaining to scheduled medical procedures.Going over disclosures and procedure questions with scheduled patients prior to consultation with physician.Coordinating with patient and physician to maintain patient chart with up to date lab work and required pre-op testing.Submit claims and prior authorization to insurance companies for approval prior to procedure with corresponding supporting clinical information.Insurance verification.Able to maintain highest call to appointment ratio in a staff of 24 agents. Serving patients efficiently and effectively.