Clinical Assistant Clinical Assistant

Company : TalentBurst, Inc.

Country: United States

Location : Chattanooga, Tennessee

Post: Fri, 10 Mar 2023 06:32:02 GMT

Expires: Fri, 07 Apr 2023 23:59:59 GMT

Apply Job : Apply Online

—————————— Job Description ——————————

Title:Clinical Assistant

Location: Chattanooga. TN

Duration: 03+ Months

Job Profile Summary

Supports customer service activities and initiatives for a number of products or clients including but not limited to the Case Management and Utilization Management departments.

Job Description

Job Responsibilities

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-19 vaccine mandate.

Job Qualifications

Education

o High School Diploma or equivalent

Experience

o 1 year – Customer service experience is required

SkillsCertifications

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-9-CM, CPT, HCPCS and UB-92 coding, UHDDS coding guidelines, AHA Coding Clinic

o Ability to talk and type simultaneously in a clear and concise manner while interacting with customers