Job description

ESSENTIAL DUTIES and RESPONSIBILITIES:

Provide administrative assistance to nurse case managers.

· Review referrals to identify possible high dollar concerns and case management needs; upload case referrals for potential case management referrals

· Stop Loss notification for potential high dollar claims

· Create cases in the Utilization Management Web

· Provide admin support to assigned nurses

· Monitor cases under high dollar case type; close cases when no further needs are identified

· Perform data entry and maintain complete and detailed documentation of case information in the UM Web and Eldorado computer systems

· Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis

KEY COMPETENCIES:

· Strong written and verbal communication skills

· Ability to make cold calls

· Proficient in Microsoft Excel, Word and Outlook

· Ability to organize, prioritize, and multitask in a fast-paced/deadline driven environment

· Demonstrate ability to work independently with excellent judgment

· Accurate data entry skills (40wpm)

· Knowledge of medical terminology; ICD-10, CPT & HCPCS coding desirable.

· Excellent interpersonal and communication skills

· Strong customer orientation

QUALIFICATIONS:

· Prior experience in customer service and/or medical background.

· Prior insurance and/or claims background

· Prior experience in a medical front office or hospital patient intake, medical claims processing, or an equivalent combination of education and experience.

· Associate Degree preferred in business, management, or related field

Physical and Mental Requirements:

· Ability to safely and successfully perform the essential job functions with or without a reasonable accommodation, including meeting qualitative and/or quantitative productivity standards

· Ability to maintain regular, punctual attendance

· Ability to sit for 6-8 hours

· Constant use of computer keyboard and mouse; repetitive use of both hands

· Occasional to frequent twisting of neck; frequent bending of neck and at waist

Schedule: 8am-4:30pm or 8:30am - 5:00pm PST

This job description is not an exclusive or exhaustive list of all job functions that an employee in this position may be asked to perform. Duties and responsibilities can be changed, expanded, reduced or delegated by management to meet the business needs of HealthComp.

Job Type: Full-time

Pay: $35,000.00 - $40,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Experience:

• Customer service: 1 year (Preferred)
• Medical terminology: 1 year (Preferred)
• Computer skills: 1 year (Preferred)

Work Location: Remote

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