- 3 years customer service experience required
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Managed Review Coordinator
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Managed Review Coordinator
1 week ago
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Utilization Review Coordinator
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Institutional Review Board Coordinator
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Institutional Review Board Coordinator
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Director of Ems
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Registered Nurse
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Operator, Flex/lt
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Referral Coordinator
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Planner, Maintenance
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Fusion Dynamics Farmers, United StatesWe are looking for enthusiastic trainees starting in summer 2024 in Lippstadt for the profession of personnel services clerk (m/f/d) at Farmers. WHAT TO EXPECT: * You conduct job interviews, hire personnel and coordinate their deployment * You review the job and applicant market ...
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Rn Hospice Patient Care Manager
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LVN Patient Care Manager Assistant
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Telephonic Rn Case Manager
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Office Manager
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Horizon Ventures Richardson, United StatesAt the earliest possible date, we are looking for you as a *Team Leader for Signaling and Control Technology (m/f/d)* for DB InfraGO AG for the Berlin-Dresden corridor at the *Berlin location*. · *Your tasks:* · * You ensure the contract-compliant and quality-oriented implementat ...
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Assistant Project Manager
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Physician Review Coordinator - Addison, Texas, United States - Concentra Career Choice
Description
Overview:
From our Dallas corporate headquarters to our clinics, worksites, and mobile locations, Concentra colleagues remain focused on our driving purpose: to provide superb patient and employer experience by delivering the highest quality healthcare in an efficient, affordable, caring manner.
A healing focus
A selfless heart
A tireless resolve
Position Summary
Working from instructions and pre-established guidelines, under general supervision, assigns medical necessity requests to a qualified reviewer and follows-up to ensure timely determination is delivered based on state/URAC guidelines in accordance with Concentra policies, practices and procedures.
Responsibilities:
The Details
Communicates directly with customer and physician advisor and tracks cases to ensure case is completed and returned to customer within established time requirements.
Receives and reviews physician review requests to ensure that all necessary information is available and contacts customer if additional information is required.
Upon receipt of completed determination, reviews for spelling and grammatical errors, appropriate application of state guidelines, ensures that all questions have been addressed, and releases the final determination to requesting customer.
Works any assigned physician review queue and/or communications queue.
Seeks assistance of more experienced Physician Review Coordinator (PRC) or Supervisor to troubleshoot problem cases.
Responds appropriately to customer or provider complaints. Refers complaint calls to Supervisor, QA Manager, or Director.
Performs other duties as assigned.
Qualifications:
Education/credentials
High School diploma/GED required
1-2 years college preferred
Medical Assistant or Medical Records certification preferred
Job-related experience
Experience with medical terminology, CPT/ICD codes preferred
Job-related skills/competencies
Customer focused
Team oriented
Good telephone etiquette and customer service orientation
Ability to handle confidential information
Knowledge of Microsoft Word and Excel and ability to learn new software applications.
Team oriented
Strong written, oral and interpersonal communication skills
Ability to manage time effectively, set priorities, accommodate multiple demands for time and resources.
Working conditions/physical demands
Office environment
