Offer summary

Qualifications:

High School Diploma required., 3 years of experience in health care claims/service areas or office support., 2 years of experience in a health care/managed care setting preferred., Knowledge of CPT and ICD-10 coding is a plus..

Key responsabilities:

Perform administrative support related to member or provider services, including benefit verification and authorization management.

Review authorization requests for initial determination and manage triage for clinical review.

Provide general support and coordination services, including answering calls and researching information.

Assist with reporting, data tracking, and dissemination of information related to Continuity of Care and Peer to Peer reviews.

Job description

LOCATION
100% Remote

DURATION
6 month contract to hire

JOB DUTIES

Performs member or provider related administrative support which may include benefit verification, authorization creation and management, claims inquiries and case documentation.
Reviews authorization requests for initial determination and/or triages for clinical review and resolution.
Provides general support and coordination services for the department including but not limited to answering and responding to telephone calls, taking messages, letters and correspondence, researching information and assisting in solving problems.
Assists with reporting, data tracking, gathering, organization and dissemination of information such as Continuity of Care process and tracking of Peer to Peer reviews.

QUALIFICATIONS

Education Level: High School Diploma
3 years of experience in health care claims/service areas or office support.

PREFERRED QUALIFICATIONS

2 years of experience in health care/managed care setting or previous work experience within division
Knowledge of CPT and ICD-10 coding.
Previous call center experience highly desired.

Required profile