Job Details

Job Title: Clinical Assistant

Location: REMOTE, but must be within travel distance to Chattanooga, TN!

Job Type: Full Time / 8:00am-5:00pm

Position Summary

We are seeking a dedicated and detail-oriented Clinical Assistant to support customer service activities across various departments, including Case Management and Utilization Management. This role is essential in ensuring smooth communication, accurate documentation, and efficient coordination of healthcare services.

Key Responsibilities

• Screen and route incoming calls, faxes, and digital requests to appropriate departments (UM/CM).

• Identify and refer cases to Case Management or Transition of Care as needed.

• Investigate and resolve customer inquiries and claims while maintaining departmental goals.

• Accurately document and enter data into systems following departmental guidelines.

• Communicate UM decisions and provide guidance to members, hospitals, and providers.

• Search and input appropriate diagnosis/procedure codes during the authorization process.

• Participate in required training and testing; attendance is mandatory.

• Adhere to rotating schedules and work overtime as needed.

Qualifications

Education:

• High School Diploma or equivalent required.

Experience:

• Minimum 1 year of customer service experience required.

• Experience with Dual-SNP plans, appeals/grievances, and pre-authorization preferred.

Skills & Certifications:

• Proficient in Microsoft Office (Outlook, Word, Excel, PowerPoint).

• Strong oral and written communication skills.

• Excellent interpersonal, organizational, and time management abilities.

• Ability to work independently and collaboratively in a fast-paced environment.

• Sound decision-making and problem-solving skills.

• Knowledge of medical terminology and provider reimbursement methodologies.

• Familiarity with ICD-9-CM, CPT, HCPCS, UB-92 coding, and AHA Coding Clinic.

• Ability to talk and type simultaneously with clarity and professionalism.

• Experience with EMR systems and medical assisting is a plus.

• Bilingual candidates are strongly encouraged to apply.

Top Skills

• Medical Assisting

• Electronic Medical Records (EMR)

• Customer Service

• Pre-Authorization

• Medical Terminology

If you're passionate about healthcare, thrive in a dynamic environment, and are committed to delivering exceptional service, we'd love to hear from you!

Pay and Benefits

The pay range for this position is $19.25 - $19.25/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Jul 17, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email ...@actalentservices.com ( ...@actalentservices.com) for other accommodation options.