Provider Access Coordinator

Provider Access Coordinator role to support clinical operations and connect members with high-quality, cost-effective in-network providers and resources. Responsibilities include verifying provider network status, directing members to in-network options, assisting with precertification, case management, and Care Navigation programs, linking members to specialists and community resources, coordinating access to providers and health benefits, receiving and routing calls, collecting clinical information for medical necessity reviews, communicating with providers about precertification status, documenting all case activities, engaging clinical staff for consultations, coordinating appeals when requested, completing tasks and special projects, assisting with departmental reporting, participating in meetings, and maintaining HIPAA confidentiality.