Clinical Support Coordinator

Mass General Brigham Health Plan
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
Jul 29, 2025
The Clinical Support Coordinator is responsible for providing administrative support to the Care Managers (CM) and processing authorizations and non-contracted provider referrals, notifications in accordance with established contractual, benefit and clinical policies and guidelines. The primary accountabilities of the position include the research, analysis, adjudication and data entry of service requests and notices received by fax, telephone, mail, email or electronically. The incumbent is also responsible for ensuring that service requests, notices and acknowledgements are processed in a timely, accurate manner in compliance with performance standards regarding telephone service levels and authorization/referral turnaround time and quality. Additionally, the incumbent will assist in various care management and member outreach initiatives and serve a primary role in the research of demographic information, conducting of surveys, generation of reports and other projects and duties as assigned. Essential Functions -Provide support to UM Care Managers to ensure provider and member customer satisfaction. -Respond in a timely and accurate manner to internal and external customer inquiries regarding Mass General Brigham Health Plan and Clinical administrative policies and procedures. -Strong knowledge and understanding of processing requests per Medicare, Medicaid, and commercial lines of business. -Process outpatient and inpatient authorizations/referrals using appropriate criteria for approval. -Achieve and maintain compliance with telephone accessibility and authorization/referral performance standards. -Process online and faxed authorization requests using desktop procedures. -Upload clinical information to the appropriate authorization in Mass General Brigham Health Plan''s online provider portal. -Enter and/or update clinical information as directed by Care Managers. -Lead and/or collaborate with other Mass General Brigham Health Plan departments in efforts to achieve success in a member care/case management. -Provide support for various care management and member outreach initiatives. -Provide alternate coverage during staff absences and position vacancies, as directed. -Other duties as assigned with or without accommodation. Education High School Diploma or Equivalent required or Trade/Technical/Vocational Diploma Related Field of Study preferred Experience At least 2-3 years of administrative Assistant or Secretarial experience required Knowledge, Skills & Abilities Proficiency with office procedures and equipment i.e. filing, copying, scanning, printing and faxing. Proficiency in MS Office. Ability to proofread and edit written documents. Ability to use phone system. Managing one's own time and the time of others. Strong verbal & written communication skills. Strong interpersonal, written and oral skills. Ability to use standard office equipment. Familiarity with medical terminology. Working Conditions This is a remote role that can be done from most US states Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.