Jobs
>
Vergennes

    Physician Review Coordinator - Addison, United States - Concentra

    Concentra
    Concentra Addison, United States

    4 weeks ago

    Show more Collapse job
    Concentra background
    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. We do this by putting all customers (internal and external) first and by displaying:

  • 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.
  • Assigns cases to appropriate/qualified physician advisor based on case requirements for specific physician specialty, experience, and state licensure requirements.
  • 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.
  • Ensures a case is completed and returned to customer based on promised return date.
  • 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

  • 1 - 3 years customer service experience required
  • Prefer telephone call center and/or medical office 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

    Additional Data

    This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.

    Concentra is an Equal Opportunity Employer M/F/Veterans/Disabled

    Need help finding the right job?

    We have other current jobs related to this field that you can find below

  • Mauser Packaging Solutions

    Operations Manager

    1 week ago

    Mauser Packaging Solutions Addison, United States

    The Operations Manager is responsible for leading day-to-day operations of a manufacturing location/area including safety, quality, efficiencies, and meeting customer expectations. Provides leadership to supervision and employees and ensures they have the proper tools to perform ...

  • Raytheon Technologies

    Senior Supplier Quality Engineer

    2 weeks ago

    Raytheon Technologies Vergennes, United States Full time

    Date Posted: · Country: · United States of America Location: · HVT01: S&IS (FUS) - Vergennes 100 Panton Rd, Vergennes, VT, 05491 USA Position Role Type: · Onsite Role Overview: · Collins Aerospace in Vergennes, Vermont has an exciting Supplier Quality Engineering opportun ...

  • Premier Mechanical Inc

    Purchasing Agent

    1 week ago

    Premier Mechanical Inc Addison, United States

    Overview We are looking for a reliable and strategic Purchasing Agent to join our growing team. You will manage procurement activities, negotiate with suppliers, and ensure the prompt delivery of quality products and services. Your skills in sourcing strategies and cost reduction ...

  • SmartHire Inc.

    Head of Accounting and Controllership

    3 days ago

    SmartHire Inc. Addison, United States

    Our client, a leading creator, manufacturer, and marketer of food flavorings and ingredients serving both sweet and savory end markets is searching for an experienced Head of Accounting and Controllership to join their team. This position will be hybrid and located in the Addison ...

  • PAXXUS

    Regional Sales Manager

    3 weeks ago

    PAXXUS Addison, United States

    Position Overview: · PAXXUS is seeking a motivated and results-driven Regional Sales Manager to join our team and support our existing and potential customers across a designated geographical region. As a Regional Sales Manager, you will play a key role in managing relationships ...

  • Maricopa Community Colleges

    Program Specialist

    3 weeks ago

    Maricopa Community Colleges Vergennes, United States Full time

    Salary Range · 30K Livable Wage · MCCCD is committed to a $30,000 Livable Wage: $ (rounded) for regular full-time employees; Not Eligible: OSO/OYO, Specially Funded, Non-Classified · Grade · 109 · Work Schedule · Monday - Friday, 8am - 5pm · Summer Hours: Monday - Thursday, 7 ...

  • Concentra

    Customer Advocacy Representative

    1 week ago

    Concentra Addison, United States

    Overview · Please be advised, if you are viewing this position on Indeed, that the salary rate/range set forth herein was provided by Indeed. Concentra's market specific rate/range will be provided during the interview process. · Position Summary: The Customer Advocacy Represent ...

  • Romexterra Construction

    Water Mitigation Project Manager

    5 days ago

    Romexterra Construction Addison, United States

    About US: · Romexterra Restoration has been the leading provider of water damage, fire damage, mold remediation, and more in the Chicagoland area. · Position Overview: · We are seeking a skilled Water Mitigation Specialist with a minimum of 5 years of experience and IICRC Certif ...

  • Wingstop

    Executive Assistant

    1 week ago

    Wingstop Addison, United States

    WHO WE ARE · We're not in the wing business. We're in the flavor business. It's been our mission to Serve the World Flavor since we first opened in 1994, and we're just getting started. 1997 saw the opening of our first brand partner operated Wingstop location, and by 2002 we had ...

  • The Royal Group

    Project Manager

    1 week ago

    The Royal Group Addison, United States

    The Royal Group , a subsidiary of Schwarz Partners, is currently seeking a Project Manager to support our Addison, IL facility. · Are you a dynamic highly organized professional with exceptional communication skills and a knack for teamwork? If so, The Royal Group is looking f ...

  • SmartHire Inc

    Head of Financial Planning

    2 weeks ago

    SmartHire Inc Addison, United States

    Company Overview · Our client, a diversified developer, manufacturer, and marketer of food flavorings and ingredients, serving both sweet and savory end markets is searching for a Head of FP&A to join their growing team. The role will be hybrid and located in the Addison, IL offi ...

  • Common Ground Capital

    Assistant Community Manager

    4 weeks ago

    Common Ground Capital Addison, United States

    Salary: $50,000 - $65,000 per year depending on experience with bonus opportunities. · Tremendous opportunity for advancement with a fast-growing company. Health, dental and vision insurance provided at no cost to the employee. Spouse and children insurance costs provided but emp ...

  • Ferguson Enterprises

    Installation Coordinator

    3 hours ago

    Ferguson Enterprises Addison, United States

    Proactively develop and maintain relationships with an assigned customer base, including key accounts and ensuring their satisfaction with our products and services. Collaborate with sales teams to understand the customer requirements. Review and mod Installation, Appliance, Coor ...

  • Minol USA

    Implementation Specialist

    1 week ago

    Minol USA Addison, United States

    Job Description · Job DescriptionSummary: Oversee the implementation of new contracts, set up basic system parameters, coordinate all components required to implement a timely and successful program start up. · Essential Duties and Responsibilities: include the following. Other d ...

  • Actus Consulting Group

    Export Supervisor

    1 week ago

    Actus Consulting Group Addison, United States

    Japanese logistics company is seeking an Export Supervisor. · GENERAL POSITION SUMMARY: · This position is responsible for managing export department staff as well as handling exporting customer's freight · smoothly, safely, accurate and quickly to the destination and bring a pr ...

  • Mauser Packaging Solutions

    Operations Manager

    4 days ago

    Mauser Packaging Solutions Addison, United States

    The Operations Manager is responsible for leading day-to-day operations of a manufacturing location/area including safety, quality, efficiencies, and meeting customer expectations. Provides leadership to supervision and employees and ensures they have the proper tools to perform ...

  • Mauser Packaging Solutions

    Operations Manager

    2 weeks ago

    Mauser Packaging Solutions Addison, United States

    The Operations Manager is responsible for leading day-to-day operations of a manufacturing location/area including safety, quality, efficiencies, and meeting customer expectations. Provides leadership to supervision and employees and ensures they have the proper tools to perform ...

  • The LaSalle Group

    Income Tax Manager

    1 day ago

    The LaSalle Group Addison, United States

    LaSalle Network is partnering with a dynamic, privately held industrial manufacturing client with annual revenues exceeding $300 million. Located near Elmhurst, Illinois, this company is dedicated to producing top-tier products while maintaining the highest standards of quality a ...

  • Jobot

    Signals Engineer

    3 weeks ago

    Jobot Addison, United States

    Job Description · Job DescriptionThis Jobot Job is hosted by: Amber Wood · Are you a fit? Easy Apply now by clicking the "Apply Now" buttonand sending us your resume. · Salary: $100,000 - $150,000 per year · A bit about us: · For more than a century, we have helped create infrast ...

  • SunSource

    Market Manager

    2 weeks ago

    SunSource Addison, United States Outside Sales & Sales Management Roles

    The Construction and Crane Market Manager is responsible for driving the sales growth of the service & repair business within the defined geography. This role will partner with existing Account Managers to provide on-site support, joint calls and opportunity identification. In ad ...