The RightFax Coordinator handles faxes sent by providers or members to ensure quality care for our members. The RightFax Coordinator interacts with providers and members to provide a seamless transition from medical authorization requests through approval or review by our care management teams. This role oversees documentation that relates to many of Healthfirst departments and all lines of clinical business.
Please note this is a Telecommuter role.
Duties and Responsibilities:
- Ensures all received faxes and service authorizations are correctly logged in which entails verifying member/provider information, records, and personal health information. Appropriately logs into correct member record and/or re-route faxes to the appropriate department, if necessary.
- Assesses faxes and escalates matters to the appropriate clinical and non-clinical teams, as needed.
- Processes members’ electronic documents, files for inaccuracies, and any other missing data.
- Creates service authorizations in the appropriate PHI system, makes determinations as to whether or not they are approved, and escalates matters to our Utilization Management team as appropriate.
- Manages provider and member calls regarding authorizations, outstanding information, and for any other relevant purpose.
- Accurately processes CMS organizational dismissals.
- Additional duties as assigned.
Must be able to work Tuesday to Saturday 8 am – 5 pm
- Relevant prior experience such as administrative or clerical experience in a healthcare environment.
- Language preferences – Spanish, Russian, French, Creole, Mandarin, Cantonese.
- Excellent time management, communication, critical thinking, and problem-solving skills
- Experience using Microsoft Excel with the ability to edit, search, sort/filter and other Microsoft and PHI systems
- WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.
EEO Law Poster and Supplement
Healthfirst is a provider-sponsored health insurance company that serves more than 1.4 million members in downstate New York. With more than 4,000 employees, a network of nearly 30,000 providers, and revenues in excess of $8.6 billion, Healthfirst is one of the largest health plans in the New York City area.
Our members are our North Star, and our mission is guided by their needs and preferences in ensuring a superior experience and access to the highest quality healthcare when and where they need it. Healthfirst’s commitment to quality and member satisfaction has helped us earn top ratings for HMO health plans in New York City. We know that employees shape our company and connect us to our communities, and we look to recruit and retain intelligent, driven leaders who are passionate about healthcare and embody our five culture drivers:
Dream Big, Plan Wisely
Break Down the Walls
Think Critically, Speak Up, Deliver with Pride
Inspire Through Trust, Lead By Example