Care Review Processor
About this role
Company Description
Job Description
Job Title: Care Review Processor
Duration: 4+ months contract
Location: Texas USA 79902
Hours: Mon- Fri 8:00 AM to 5:00 PM
Top Three Skill Sets: Customer Service, Computer Skills and medical terminology
Job Description:
- Provide computer entries of authorization request/provider inquiries by phone, mail, or fax. Including: Verify member eligibility and benefits, Determine provider contracting status and appropriateness, Determine diagnosis and treatment request Assign billing codes (ICD-9/ICD-10 and/or CPT/HCPC codes), Determine COB status, Verify inpatient hospital census-admits and discharges, Perform action required per protocol using the appropriate Database.
- Respond to requests for authorization of services submitted to CAM via phone, fax and mail according to Client’s operational timeframes.
- Participates in interdepartmental integration and collaboration to enhance the continuity of care for Client members including Behavioral Health and Long Term Care.
- Contact physician offices according to Department guidelines to request missing information from authorization requests or for additional information as requested by the Medical Director.
- Provide excellent customer service for internal and external customers.
- Meet department quality standards, including inter-rater reliability (IRR) testing and quality review audit scores.
- Notify Care Access and Monitoring Nurses and case managers of hospital admissions and changes in member status.
- Meet productivity standards.
- Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
EDUCATION:
- Accurate data entry at 40 WPM minimum.
- Required Education: High School Diploma/GED
- Required Experience: 1-4 years of experience in a Utilization Review Department in a Managed Care Environment.
- Previous Hospital or Healthcare clerical, audit or billing experience. Experience with Medical Terminology
Qualifications
Additional Information
All your information will be kept confidential according to EEO guidelines.
Frequently Asked Questions
Is the salary disclosed for the Care Review Processor position at integratedresourcesinc?
The salary for this Care Review Processor role at integratedresourcesinc is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
Where is the Care Review Processor position at integratedresourcesinc located?
This Care Review Processor role at integratedresourcesinc is based in El Paso, El Paso, TX, United States, TX, us. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the Care Review Processor role at integratedresourcesinc full-time or part-time?
This is listed as a Full time position. It is posted as a Care Review Processor role at integratedresourcesinc.
How do I apply for the Care Review Processor position at integratedresourcesinc?
Click the "Apply Now" button on this page. You will be redirected to integratedresourcesinc's official application portal hosted on smartrecruiters where you can submit your application directly.
When was the Care Review Processor job at integratedresourcesinc posted?
This Care Review Processor position at integratedresourcesinc was posted on Jul 17, 2017. Apply as soon as possible — early applications are often reviewed first.
Care Review Processor
integratedresourcesinc
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