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    Case Assistant - Akron, United States - Summa Health System

    Summa Health System
    Summa Health System Akron, United States

    2 weeks ago

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    Description
    Case Assistant

    SummaCare E Market St, Akron, OH

    Part-Time / 16 Hours (4 days - 1p-5p Tues-Fri)

    SummaCare is a Summa Health entity that offers health insurance in northern Ohio.

    As a regional, provider-owned health plan, SummaCare is based in Akron, Ohio, and provides Medicare Advantage, individual and family and commercial insurance plans.

    SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2024 by the Centers for Medicare and Medicaid Services (CMS).

    Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits.

    Summary:


    Receives and reviews incoming authorization requests for all lines of business (Medicare Advantage, Commercial, Exchange, etc.) Supports Authorization Coordinators and Utilization Management by entering Authorization requests in correct format, attaching necessary clinical and forwarding for nurse review within HealthEdge application.

    Processes administrative authorizations for correct claims payment. Works with internal/external customers to acquire all necessary information for clinical review and claims payment.

    Requires knowledge of all plan types and regulatory requirements to ensure requests are timely and entered correctly in a fast-paced environment.

    Possible overtime work during peak periods and vacations. Hybrid schedule with work from home and in office requirements.

    Formal Education Required:

    a.
    High School Diploma/GED required.
    b

    Required Licenses and/or Certificates:
    None required.

    Experience & Training Required:

    a.

    One (1) year of experience to include the following: combination of clerical and customer service experience in any industry with any or all of the following:

    Clerical support duties:
    data entry, typing, and/or filing

    Customer service experience:
    telephone customer service, call center experience, and/or experience working with the public in any industry. Experience with physician office/medical coding preferred
    b.Typing of 30 wpm with accuracy required.
    c

    Strong communication skills:
    verbal and written.
    d.
    Solid typing skills
    e

    Microsoft Computer skills:
    Outlook, Word, Excel

    Other Skills, Competencies and Qualifications:
    a.
    Organizes and manages time to accurately complete tasks within designated time-frames in fast paced environment.
    b.
    Demonstrate empathy, confidence, proper tone, and service-oriented attitude over the telephone.
    c

    Flexible:
    ability to adjust work hours to meet business demands.
    d.
    Ability to effectively interact with populations of patients/customers with an understanding of their needs for self-respect and dignity.
    e.
    Ability to understand verbal instructions and written instructions, policies, and procedures.
    f.
    Accurate verbal and written skills.


    Level of Physical Demands:
    a.
    Sit and/or stand for prolonged periods of time.
    b.
    Bend, stoop and stretch.
    c.
    Lift up to 20 pounds.
    d.
    Manual dexterity to operate computer, phone, standard office machines.

    $15.91/hr - $19.09/hr
    The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials.

    Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay.

    We believe in the importance of pay equity and consider internal equity of our current team members when determining offers.

    Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.
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