Clinical Care Advocatee
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AI Summary
The Clinical Care Advocate manages the reauthorization process for medical visits by coordinating with providers and stakeholders to ensure continuous patient care. They maintain accurate documentation, track claims, and provide transparent communication regarding case status.
Why Bardavon?
At Bardavon, we treat our people right.
We hire exceptional people who are exceptional at their jobs. We are dreamers. We are driven, idealistic, committed, and optimistic. As a company, we are irreverent about the status quo and confident in our ability to change the Workers’ Compensation industry and healthcare in America.
What You’ll Do:
The Clinical Care Advocate contributes to the department’s efforts to obtain and process reauthorization of visits based on physician scripts and signed plans of care from approved network providers in an organized and process-oriented manner that meets patient and customer expectations.
- Maintain accurate and timely documentation of cases by working with Visit Management Associates to track visit notes, claims, and coordinating upcoming medical visits or provider notifications as required by stakeholders.
- Follow up on all referral cases at the time of reauth to determine the plan of care.
- Obtain additional orders for cases continuing care and obtain authorization with required stakeholders.
- Work to ensure patients do not experience a lapse in care at the point of reauthorization.
- Advise stakeholders of claim status as needed for transparent and thorough communication.
- Execute tasks delegated to & from Case Administrators including questions/requests from stakeholders, case utilization reviews, and other requirements to support case management.
- Execute tasks delegated to & from Coaching/QA when additional visits are requested, utilization review is needed, or there are clinical questions from stakeholders.
- Optimize care management by delivering exceptional customer service and demonstrating empathy to support positive outcomes.
- Streamline workflows to enhance efficiency, improve case transparency, and facilitate effective communication among stakeholders.
- Use critical thinking and problem-solving skills as situations arise.
- Be detail oriented to ensure all information is entered and properly documented for managing the reauthorization.
- Work through queues efficiently and accurately to minimize delays in reauthorization processing.
- Communicate professionally, effectively and succinctly in verbal and written formats.
- Execute other duties/projects as assigned.
Must Have’s:
- High School Diploma or Equivalent.
- Strong critical thinking skills
- Strong communication skills, verbal and written
- Proficiency in Microsoft Office Suite, CRM, Salesforce
- Knowledge of Raintree, bNOTES
- Proven ability to work both independently and cross-functionally within a team environment.
- Ability to anticipate problems and visualize solutions on a proactive basis.
- Ability to make decisions in the absence of detailed instructions and work independently or in a team environment.
- Flexible in the methodology, reliable, self-starter, results oriented
Nice To Have’s:
- Medical Background
- Post-secondary education
- Bilingual Spanish
Compensation:
- The range of base salary for this role is between $39,000 to $46,000 plus benefits. Please note that base salary is a guideline and will vary based on factors such as work location, qualifications, skill level, and competencies. Additionally, salary is just one component of Bardavon’s total rewards package. Depending on the role, employees may also be eligible for a bonus program and/or incentive pay.
Timeline:
- Our Talent Acquisition team will review your resume and respond.
- If there is a match, we will give you a call.
- If there is not a match, we promise to let you know and will stay in touch for future roles.
We do Workers’ Comp differently.
Bardavon Health Innovations is a proactive Workers’ Compensation partner that connects all stakeholders to better manage claims and offer work readiness solutions through rehabilitation therapy. We share a holistic analysis of the claim so America’s injured workers can achieve optimized outcomes and return to full-duty employment.
Bardavon offers a complete benefits package, including medical, dental, and vision insurance; 401(k) with company match; and generous paid time off.
EOE M/F/D/
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