Jobs and Careers
MA
Clinical Support Coordinator
Mass General BrighamSomerville, United Statesfull_timeVerifiedPosted 30 Jul 2025
About the role
Site: Mass General Brigham Health Plan Holding Company, Inc.
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.
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
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.
Qualifications
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.
Additional Job Details (if applicable)
Working Conditions
- This is a remote role that can be done from most US states
Remote Type
Remote
Work Location
399 Revolution Drive
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
Pay Range
- /
Grade
3
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