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Job Description
o Screen incoming calls and / or faxes or other digital format for UM and / or CM and direct calls / faxes / other digital requests to the appropriate area.
Identify and refer cases appropriately to the Case Management and / or Transition of Care department.
o Receiving, investigating and resolving customer inquiries and claims. Maintain departmental goals. Perform projects, review and handle reports as assigned.
o Load complete organization determination / notification for services designed by internal policy. Clearly document and key data in to the appropriate system using departmental guidelines.
o Interact with membership, hospital and provider staff, advising of UM decision, status organization determinations, giving direction as necessary.
o Search for and key appropriate diagnosis and / or procedure code as part of the notification / prior authorization process.
o Must be able to pass required testing.
o Participation and attendance are mandatory.
o This position requires flexibility, due to rotations in schedules, and requires adherence to assigned schedules.
o Work overtime as required
Quals
All applicants will be advised that Client, as a federal contractor, may be required to implement a COVID- vaccine mandate.
Job Qualifications
o High School Diploma or equivalent
Experience
o year - Customer service experience is required
Skills Certifications
o Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
o Proficient oral and written communication skills
o Proficient interpersonal and organizational skills
o Exceptional time management skills
o Ability to work independently under general supervision and collaboratively as part of a team in a fast paced environment
o Independent, Sound decision-making and problem-solving skills
o If current employee with the company, must meet minimum performance expectations
o Extensive knowledge of all aspects of Utilization Management, Care Management, and Behavioral Health.
o Knowledge and understanding of Medical terminology
o Solid knowledge and understanding of provider reimbursement methodologies, ICD CM, CPT, HCPCS and UB- coding, UHDDS coding guidelines, AHA Coding Clinic
o Ability to talk and type simultaneously in a clear and concise manner while interacting with customers
EEO :
Full Time
Business Services
$34k-40k (estimate)
05/14/2024
07/13/2024
mindlance.com
KING OF PRUSSIA, PA
1,000 - 3,000
1999
Private
$50M - $200M
Business Services
Mindlance is a provider of technical staffing, product engineering and direct sourcing solutions for enterprises.
The job skills required for Clinical Assistant include Customer Service, Time Management, Written Communication, Flexibility, Problem Solving, Organizational Skills, etc. Having related job skills and expertise will give you an advantage when applying to be a Clinical Assistant. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Clinical Assistant. Select any job title you are interested in and start to search job requirements.
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