Health Services Specialist

🔥 6 minutes ago

☕ Washington – Remote

☕ Washington – Remote

💵 $24 - $30 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 2%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Comagine Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1973

💼 Consulting

🏥 Healthcare

🤝 Non-profit

Consulting • Healthcare • Non-profit

Comagine Health is a national nonprofit health care consulting organization that partners with providers, payers, public agencies, community organizations and consumers to improve health care quality, equity, and outcomes. It offers systemwide quality improvement, care management, data solutions, research and evaluation, and COVID-19 response services, using health information exchange and health IT to inform public health surveillance and program design. Comagine focuses on supporting community health, behavioral health, and patient-centered initiatives through technical assistance, evaluation, and collaborative systems-level work.

📋 Description

• Assist healthcare providers with submitting medical service requests, using online provider portals, understanding documentation requirements, and navigating medical management processes • Receive and coordinate referrals, prior authorization requests, utilization review cases, and case management requests through electronic portals, phone, fax, and other communication channels • Verify service requests are complete and accurate, identify missing medical information, and follow up with providers or other appropriate contacts • Answer inbound calls, respond to provider and member questions, document interactions, and help resolve routine inquiries and concerns • Enter information into electronic healthcare management systems, upload medical documentation, organize case files, and maintain detailed records • Work alongside clinical reviewers and physicians to process review outcomes, verify determination information, and prepare accurate notification letters • Help schedule assessments, coordinate transportation or accommodation requests, obtain necessary consents, and assist with non-clinical care coordination • Communicate with nurses, physicians, case managers, and other healthcare professionals to support timely processing of requests • Complete scripted clinical review screenings and refer cases requiring clinical judgment to qualified clinical staff • Communicate service determinations to providers following physician review, as directed • Support quality assurance reviews, training activities, and process improvements • Assist with case closure and maintain compliance with program requirements

🎯 Requirements

• High school diploma or GED • At least 2 years of related work or customer service experience • At least 1 year of experience working in a healthcare setting • Strong written and verbal communication skills • Excellent attention to detail, organization, and follow-through • Ability to manage multiple priorities while maintaining accuracy • Strong customer service skills and a professional, solutions-focused approach • Ability to work collaboratively with healthcare providers, clinical professionals, and team members • Comfort using computers, electronic records, and multiple software applications • Preferred: 2 or more years of healthcare experience • Preferred: Experience as a Medical Assistant, Nursing Assistant, Patient Services Representative, Medical Office Specialist, or Healthcare Coordinator • Preferred: Post-secondary education or certification in healthcare administration or a related field • Preferred: Familiarity with prior authorizations, utilization management, medical terminology, case management, or insurance processes • Preferred: Experience working with electronic health records, healthcare portals, or medical management systems • No professional healthcare license is required for this position

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