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Salary: USD 39,000 - 46,000 / annual
Bardavon Health Innovations is seeking a Clinical Care Advocate to support the reauthorization and case management process for workers' compensation claims. This role bridges clinical operations and patient care, ensuring continuity of treatment and seamless communication across stakeholders.
Key Responsibilities:
- Obtain and process reauthorization of visits based on physician scripts and signed plans of care from approved network providers
- Maintain accurate, timely documentation of cases by coordinating with Visit Management Associates to track visit notes, claims, and upcoming medical visits
- Follow up on all referral cases at reauthorization to determine the plan of care and obtain additional orders for continuing care
- Ensure patients do not experience lapses in care at the point of reauthorization
- Advise stakeholders of claim status for transparent communication
- Execute tasks delegated by Case Administrators, including questions/requests from stakeholders, case utilization reviews, and other case management support
- Execute tasks delegated by Coaching/QA when additional visits are requested, utilization review is needed, or clinical questions arise
- Deliver exceptional customer service with empathy to support positive outcomes
- Streamline workflows to enhance efficiency, improve case transparency, and facilitate effective communication
- Apply critical thinking and problem-solving skills to address situations proactively
- Maintain detail-oriented documentation and work through queues efficiently to minimize reauthorization delays
- Communicate professionally and effectively in verbal and written formats
- Execute other duties and projects as assigned
Requirements:
- High school diploma or equivalent
- Strong critical thinking skills
- Strong communication skills, both verbal and written
- Proficiency in Microsoft Office Suite, CRM, and Salesforce
- Knowledge of Raintree and bNOTES systems
- Proven ability to work both independently and cross-functionally within a team environment
- Ability to anticipate problems and visualize solutions proactively
- Ability to make decisions in the absence of detailed instructions
- Flexible, reliable, self-starter, results-oriented mindset
Nice to Have:
- Medical background
- Post-secondary education
- Bilingual Spanish capability
