Position is 100% remote - can sit anywhere in the US
Schedule is 8:30 am – 5pm EST
MUST-HAVES:
- Customer Service Experience
- Health Plan Experience
- Computer Literate
- Critical thinkers who excel at meeting productivity measures
JOB DUTIES:
- Enter authorizations from received faxes or telephone calls from providers
- Building shells
SPOTLIGHT CALL NOTES:
This is a non-clinical staff role. Candidates should be very tech savvy and have demonstrated aptitude in learning new systems and navigating through multiple computer systems simultaneously and quickly.
This role is very task-oriented and the bulk of the work will be conducted between the two systems UMK2 and QNXT. UMK2 is a system where faxes are received electronically from providers for procedure authorization. Information will be pulled from these faxes in order to build and initial shell (i.e. taking the information from the fax and any key data points and entering into QNXT). Once the initial shell is created in QNXT, the full shell must be built out. This piece requires critical thinking, looking at things like whether a provider is in or out of network, etc, and using decision trees to follow the correct process and enter the required information and codes. As a part of this process, they will reference the prior authorization matrix, follow the decision tree and enter the correct codes into the shell.
This is a very fast-paced role with high-volume production standards, and the expectation is that, once through training, they will be able to accurately process about 30 faxes per hour.
Ideally, candidates would have previously worked in a utilization management department for a health plan or have held a medical assistant position and are familiar with CPT and diagnosis codes.
Pay: 14-16/hr
#INDAS
Job Type: Full-time
Pay: $14.00 - $16.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Vision insurance
Schedule:
- 8 hour shift
Experience:
- health plan: 2 years (Required)
- QNXT/UMK2: 1 year (Required)
- CPT and diagnosis codes: 2 years (Required)
- utilization management department: 2 years (Preferred)
Work Location: Remote