Job Summary
Job Title: Clinical Admin Coordinator
Location: 100%REMOTE/ Telecommute, Must be located in Texas
Contract: 3 months contract (possible extensions)
Shift: 5 days a week, Thursday through Monday. 8am -5pm CST with a 1-hour unpaid lunch
Hours Per week: 40 hours per week.
Description:Primary Responsibilities:
Provides data entry, filing, tracking time frames and status of case files and mailing letters to patients and providers
Reviews denials and determines whether the decisions are retro/claims DOS or prospective DOS, and whether they are NCB or medically necessary
Monitors system approval queues and prints member letters, ensuring that all approvals are printed and mailed by end of business day
Prepares envelopes and letters for mailing according to the UM policy
Receives appeal requests from health plans and/ or QIO, logs request, researches and provides requested information
Works with claims department to redirect claims related appeal requests
Generates reports for analysis by department using the data entry system
Assists with CMS organization determination reports as needed
Must be able to work a flexible schedule that includes evening hours and holidays.
Required Qualifications:
High school diploma or GED equivalent
2+ years of related experience
Sound knowledge of medical terminology
Proficient software computer skills
Ability to work a 5-day, 8-hr per day, work week including weekends and holidays)
What skills/attributes are preferred (what will set a candidate apart)?
Preferred Qualifications:
Related experience in healthcare
Telephonic and/or telecommute experience
Familiarity with ICD-9 coding
Demonstrated excellent verbal and written skills
Proven ability to possess planning, organizing, conflict resolution, negotiation, and interpersonal skills
Independent problem identification/resolution and decision-making skills
Demonstrated ability to interact with individuals and with multidisciplinary teams
What is the dress code (ex: business casual scrubs etc.)? Business casual
How would you prefer to interview? (Video phone or in person? How many rounds?) Video per Teams
How to Apply
Interested candidates should submit their application online using the link below.
Apply Now
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