CLINICAL OPERATIONS REPRESENTATIVE

Who We Are:

TurningPoint Healthcare Solutions is a leader in advanced clinical and technology-enabled complex condition management. TurningPoint provides an innovative suite of specialty care management services and technologies that enable health plans and employers to improve the safety, quality, and affordability of healthcare. Through its platform and specialized team of clinical experts, TurningPoint works collaboratively with providers to deliver optimal care. TurningPoint offers condition-specific, quality-driven, value-based care management services that optimize care from diagnosis and discovery through recovery. TurningPoint’s comprehensive and integrated suite of services enhances the support individuals need, at the time they need it most. Since launching in 2015, TurningPoint has provided support to more than 50 million people nationwide across numerous clinical specialties including musculoskeletal, pain management, cardiology, wound care, ear/nose/throat, and sleep. TurningPoint’s model moves beyond denial-based care to holistic condition management that improves outcomes and reduces cost. TurningPoint is an independent organization, not owned or affiliated with a health plan or provider system.

Position Summary:

The Clinical Operations Representative will assist in daily activities servicing TurningPoint customers including processing requests received via telephone, fax and email; providing or validating request information. This position supports the Utilization Management, Payment Integrity (Claims), Client Solutions and/or Provider Relations departments.

Role and Responsibilities:

• Assist and engage customers in a call center environment with exceptional service, this includes but is not limited to answering questions, offering assistance, and providing product/service information
• Enter and process requests in an efficient and accurate manner
• Verify and update critical data impacting downstream workflows
• Review and maintain service request and call center database for completeness of information
• Review portal system usability and ease of navigation; assists with testing and support
• Perform outbound calls to members, providers and clients, as required
• Provided feedback and recommendations on workflow and database needs to improve quality and processing times, including modifications to provider portal, web design and back-end information
• Increase job knowledge by participating in educational opportunities and training
• Demonstrate ownership and explore opportunities that add value to position and enhance organization reputation
• Keeps equipment operational by following established procedures and reporting malfunctions
• Follows company policies and procedures and conducts annual performance reviews in a timely manner
• Respects and maintains HIPAA confidentiality guidelines
• Other duties as directed
  
  
  

Education, Experience and Licensure:

• Minimum of 2 years’ experience in customer service, or healthcare operations is required
• Associates Degree in a business or health related field is preferred
• Certified Medical Assistant is preferred
  
  
  

Preferred Skills:

• Phone queue experience and data entry skills
• Intermediate to advance proficiency in Microsoft Word, Excel and Outlook
• Excellent verbal and written communication skills
• Strong organizational skills; ability to multitask; commitment to customer service; ability to problem solve
• Must be able to foster a positive and productive work environment
  
  
  

Work Location: Remote (MST & CST are preferred)

Pay: Starting at $16.00 per hour

TurningPoint Healthcare Solutions is an Equal Opportunity Employer.