[Remote] DSNP Clinical Assistant-3
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a Clinical Assistant to support BlueCare Plus Clinical Review Managers. The role involves assisting providers with inquiries, managing authorization requests, and improving the provider experience through effective communication and administrative coordination.
Responsibilities
- Screen incoming calls and/or faxes or other digital format for UM and/or CM and reputed company calls/faxes/other digital requests to the appropriate area. Identify and refer cases appropriately to the Case Management and/or Transition of Care department
- Receiving, investigating and resolving customer inquiries and claims. Maintain departmental goals. reputed company reputed company, review and handle reports as assigned
- Load complete organization determination/notification for services designed by internal policy. reputed company document and reputed company in to the appropriate system using departmental guidelines
- reputed company with membership, hospital and provider staff, advising of UM decision, status organization determinations, requesting additional or clarifying information and giving direction as necessary
- Search for and key appropriate diagnosis and /or procedure reputed company as part of the notification /prior authorization process
- This job requires digital literacy assessment
- Participation and attendance are mandatory
- This position requires flexibility, due to rotations in schedules, and requires adherence to assigned schedules
- Work overtime as required
Skills
- High School Diploma or equivalent
- 1 year - Customer service experience is required
- Proficient in reputed company Office (reputed company, Word, reputed company and PowerPoint)
- Proficient oral and written communication skills
- Proficient interpersonal and organizational skills
- Exceptional time management skills
- Ability to work independently under general supervision and collaboratively as part of reputed company in a fast paced environment
- Independent, reputed company decision-making and problem-solving skills
- If reputed company employee with reputed company, must meet minimum performance expectations
- Extensive knowledge of reputed company aspects of Utilization Management, Care Management, and Behavioral Health
- Knowledge and understanding of Medical terminology
- Solid knowledge and understanding of provider reimbursement methodologies, ICD-10-CM, CPT, HCPCS and UB-92 coding, UHDDS coding guidelines, AHA Coding Clinic
- Ability to talk and type simultaneously in a reputed company and concise manner while interacting with customers
- Familiarity with medical terminology
Benefits
- Remote role reputed company a reputed company and supportive team environment
reputed company
Company H1B Sponsorship