Clinical Support Coordinator 1
Remote
Duration- 9+ months
Shift- Monday – Friday | 8:00 AM – 4:30 PM / 5:00 PM 

Summary:
The Clinical Support Coordinator I provides administrative and operational support to the Clinical Quality Review (CQR) team by coordinating medical record requests, managing case documentation, tracking responses, and maintaining accurate electronic records. This role works closely with Clinical Quality Reviewers to ensure cases are processed efficiently, turnaround times are met, and documentation is complete while delivering exceptional customer service in a remote environment.

Job Responsibilities:

• Request medical records and supporting documentation from providers via fax, secure email, telephone, or electronic medical record (EMR) systems.
• Validate provider contact information and maintain accurate department records.
• Follow up on outstanding medical record requests and document all communication appropriately.
• Receive, review, and organize incoming medical records for completeness prior to clinical review.
• Attach medical records and supporting documentation to electronic case files.
• Coordinate with Clinical Quality Review Leads and RNs regarding request status and case updates.
• Create, assign, update, and process clinical review cases accurately and within required turnaround times.
• Research provider and member information using internal applications.
• Prepare, distribute, and maintain professional correspondence and documentation.
• Perform data entry, document corrections, and document distribution.
• Monitor multiple priorities while maintaining productivity and accuracy standards.
• Maintain confidentiality of protected health information (PHI) and comply with organizational policies.
• Support continuous process improvement initiatives and contribute to a collaborative team environment.
• Deliver excellent customer service through professional verbal and written communication.

Education Requirements

• High School Diploma or GED required.

Required Skills (Top 3 Non-Negotiables)

• Detail-oriented with strong verbal and written communication skills.
• Experience using Agile.
• Strong organizational skills with professional letter writing and formatting abilities.

Preferred Skills (Nice to Have)

• Health plan and/or medical office experience with basic knowledge of managed care principles (HMO, PPO, Medicare).
• Knowledge of medical terminology.
• Previous experience supporting grievances and quality of care concerns.

Disqualifiers / Resume Red Flags

• No remote work experience.
• Spelling, formatting, or grammatical errors on the resume.

Software Skills Required

• Microsoft Office Suite (Word, Excel, Outlook, PowerPoint).
• Microsoft Excel (spreadsheet management).
• Adobe Acrobat.
• RightFax.
• Professional business letter formatting and document preparation.

 
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position's pay range is $18.00/hr - $21.66/hr.