Health Services Specialist
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Health Services Specialist coordinating provider and member healthcare requests for Comagine Health, a nonprofit healthcare consulting organization. Managing documentation, authorizations, records, and non-clinical care coordination remotely in Washington State.
Responsibilities:
- 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
Similar Jobs
Histologist
Remote CRA I training as a Histologist for ICON’s sponsor-dedicated clinical trials. Monitoring studies, maintaining documentation, and supporting patient safety and regulatory compliance.
Senior External Audit Specialist
External audit specialist leading group benefit, BCBSA, and contractual compliance audits for Capital Blue Cross health insurance operations. Coordinating auditors, documentation, corrective actions, and executive reporting.
Medical Infocomm Specialist – Medical Aesthetics
Medical aesthetics specialist delivering product education, customer support, and project execution for AbbVie’s aesthetics portfolio in Wuhan, China.
A/R Management Specialist
A/R specialist managing insurance, patient billing, appeals, and collections for Digitech, a provider of outsourced EMS billing and technology services.
Barrister
Barrister handling civil litigation advocacy and tailored client services for DAC Beachcroft’s integrated in-house chambers. Supporting fellow barristers and delivering advisory, drafting and advocacy work.
Medical Information Specialist, Italian, English
Medical Information Specialist providing Italian- and English-language healthcare product information and customer support. Handling inquiries, compliance processes, and medical information for Conduent’s clients.
Income Development Specialist – Automotive F&I
Income Development Specialist driving F&I sales growth for Safe-Guard’s automotive protection platform. Training dealer personnel and improving product sales, compliance, and profitability.
Mortgage Servicing Specialist II
Mortgage servicing specialist monitoring sub-servicers, collections, foreclosure, bankruptcy, and escrow compliance. Supporting borrowers and branches for SWBC, a financial services company.
Computational Biologist I
Computational Biologist developing Freenome’s multiomics, blood-based cancer screening assays. Applying bioinformatics and statistics to diagnostic development and FDA-regulated validation.
Medical Specialist
AbbVie immunology medical specialist promoting medicines and engaging healthcare professionals in Wenzhou. Supporting compliant market execution and adverse-event reporting.
Vaccines Specialist, Health and Science Professional
Pfizer Vaccines Specialist promoting the Vaccines Portfolio across Richmond-area healthcare customers. Driving territory sales through live and virtual engagement, account development and formulary access.
Nutrition Specialist
Nutrition Specialist coaching patients through personalized nutrition, metabolic health, and behavior strategies. Supporting Early Medical’s virtual longevity practice with data-driven care.
Global Biomarker Lead
Leading oncology clinical biomarker strategy and execution at Amgen. Advancing biomarker-driven development of innovative medicines through clinical research and cross-functional collaboration.
Site Selection Lead
Site Selection Lead securing data centers for Andromeda’s AI compute infrastructure platform. Owning market screening, technical diligence, lease negotiation, and delivery handoff across US markets.
Shop & Creator Coordinator
Remote TikTok Shop & Creator Coordinator running Panda Drum’s UGC creator pipeline. Growing TikTok Shop affiliate sales for the DTC steel tongue drum brand.
Senior Technologist, Marketo Engage
Marketo technologist configuring marketing automation, integrations, and AI features for MERGE’s health and wellness marketing agency. Supporting client programs, governance, QA, and technical roadmaps.
Account Technology Officer
Account Technology Officer advising UK strategic accounts on Broadcom product adoption, licensing consumption, and technical strategy. Aligning Broadcom solutions with client business and IT objectives.
Patient Service Specialist
Patient Service Specialist supporting UVM Medical Center’s remote Vermont primary care psychiatry operations. Providing administrative support and reliable customer service to patients, families, and care teams.
Recepcionista de Llamadas
Recepcionista remoto atendiendo dudas y reclamos de clientes PostPago de Claro Perú. Gestión de llamadas para GEA Internacional, empresa de servicios asistenciales.