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Clinical Assistant
2 months ago
At Talent Software Services, we are seeking a skilled Clinical Assistant to support our customer service activities and initiatives. The ideal candidate will have a strong background in healthcare and excellent communication skills.
Key Responsibilities:
• Screen incoming calls and/or faxes or other digital format for UM and/or CM and direct calls/faxes/other digital requests to the appropriate area.
• Identify and refer cases appropriately to the Case Management and/or Transition of Care department.
• Receiving, investigating and resolving customer inquiries and claims. Maintain departmental goals. Perform projects, review and handle reports as assigned.
• Load complete organization determination/notification for services designed by internal policy. Clearly document and key data into the appropriate system using departmental guidelines.
• Interact with membership, hospital and provider staff, advising of UM decision, status organization determinations, requesting additional or clarifying information and giving direction as necessary.
• Search for and key appropriate diagnosis and /or procedure code as part of the notification /prior authorization process.
Requirements:
• High School Diploma or equivalent
• 1 year - Customer service experience is required
• Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
• Proficient oral and written communication skills
• Proficient interpersonal and organizational skills
• Exceptional time management skills
• Ability to work independently under general supervision and collaboratively as part of a team in a fast paced environment
• Independent, Sound decision-making and problem-solving skills
• Extensive knowledge of all aspects of Utilization Management, Care Management, and Behavioral Health.
• Knowledge and understanding of Medical terminology
• Solid knowledge and understanding of provider reimbursement methodologies, ICD--CM, CPT, HCPCS and UB- coding, UHDDS coding guidelines, AHA Coding Clinic
• Ability to talk and type simultaneously in a clear and concise manner while interacting with customers
What We Offer:
Talent Software Services is a dynamic and growing company that offers a competitive salary and benefits package, as well as opportunities for professional growth and development.
