Medical Case Manager Assistant / WC Scheduler

About the role

This position does not provide any clinical review or decisions. It works directly with the Supervisor and Manager to provide additional resources to the case management staff.

Responsibilities

• Responds to phone inquiries from providers, patients, case managers, peers
• Make initial contact for case management staff
• Initial contact with providers to obtain clinical information
• Aid in case management workflow and documentation prepares routine correspondence for Case Managers, physicians, and patients
• Identify each caller/patient's needs and determine the next appropriate action, which may include clinic referral or escalating the process
• Communicate effectively with all parties, such as case managers, physicians, claims team, and ancillary providers or vendors/agencies to ensure that patient information is current, accurate, and complete
• Print and mail correspondence to all necessary parties in accordance with state regulations
• Assist incoming calls to the case management department
• Maintain documentation standards adhering to URAC standards and company policy and procedures
• Complete the assigned deliverables/billable hours per week, as assigned by your Supervisor
• Identify trends and/or issues in referral patterns and communicate them with management
• Demonstrate ability to meet administrative requirements, including productivity, time management, and Quality Assurance standards
• Maintain confidentiality-Knowledge of laws and regulations pertaining to HIPPA and PHI
• Other job duties as assigned

Requirements

• Experience in healthcare related fields
• Strong communication skills; customer service mindset; team player
• Adhere to professional standards, codes of ethics, system and department policies and procedures
• Ability to work independently to meet deadlines, as well as an excellent phone demeanor and a desire to provide exceptional customer service
• Knowledge of medical terminology, the understanding of referral criteria by client and/or jurisdictions

Qualifications

• High school diploma required
• Medical or Managed Care background preferred and/or Certified Medical Assistant
• Experience in healthcare and/or managed care related fields, Minimum of one year of working in a medical or managed care environment preferred
• Medical Terminology preferred

Skills

• Excellent typing and keyboard skills (35-40wpm)
• Ability to work in a variety of computer systems proficiently
• Ability to navigate a Windows environment, utilize Outlook, and the ability to create, edit, save and send documents utilizing Microsoft Word and Microsoft Excel
• Ability to work within a paperless environment

Benefits

N/A

Pay

N/A

Schedule

N/A