Program Assistant II

Responsibilities

• Review, analyze, and process medical cost disputes related to worker's compensation claims.
• Investigate disputes regarding reasonableness of medical fees and pharmacy fee schedules.
• Gather additional information from employers, insurers, employees, attorneys, and medical providers.
• Utilize databases and systems to track disputes, claims, and case progress.
• Prepare draft orders and documentation in accordance with applicable laws and regulations.
• Aid in preparing cases for review related to medical necessity disputes.

Requirements

• Strong written and verbal communication skills.
• Knowledge of customer service, dispute resolution, and investigative techniques.
• Ability to interpret statutes, rules, and medical documentation.
• Proficiency in Microsoft Office and working with databases.
• Basic math skills and attention to detail.
• Ability to work independently and in a team environment.
• Knowledge of medical terminology and healthcare coding is preferred.

Qualifications

• High school diploma or equivalent.
• One year of relevant experience in a similar role.

Skills

• Strong written and verbal communication skills.
• Knowledge of customer service, dispute resolution, and investigative techniques.
• Ability to interpret statutes, rules, and medical documentation.
• Proficiency in Microsoft Office and working with databases.
• Basic math skills and attention to detail.
• Ability to work independently and in a team environment.
• Knowledge of medical terminology and healthcare coding is preferred.

Benefits

• Flexible schedule.
• Professional development opportunities.
• Health insurance coverage.
• Retirement savings plan.

Pay

• $16.10 per hour.

Schedule

• Monday - Friday, 7:45 AM - 4:30 PM.