World Class Healthcare Leader is searching for Medical Review Service Coordinators
6 month assignment initially; may be extended for the right candidate
Pay rate of $ 18.00 to $21.00 per hour, dependent upon experience
What you will be doing:
- The Review Services Coordinator is a critical role in adjudicating pre-authorization coverage requests for all types of services - medical and DME.
- The work environment is fast paced and at many times complex.
- Knowledge of health plan functions is required and includes reading and interpreting contracts and coverage and understanding claims payment.
- This role includes handling a high volume of incoming calls from members and providers, managing multiple requests simultaneously and accurately and easily identifying requests that require a higher level of clinical review
- Respond with empathy to complaints and concerns from members concerning health plan benefits, account status, payment history, and medical services.
Minimum Experience Requirements:
- 2 years healthcare call center experience with emphasis in health insurance including billing,
- Pre-authorizations, benefits and eligibility.
- Working with the public with emphasis on problem solving and conflict resolution.
- 2 years experience with on-line computer systems and Microsoft Office.
- Medical terminology is required. along with Medical Coding experience with ICD-9/10, CPT and HCPCS.
If you are qualified and interested, please apply today.
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Role: Healthcare Customer Service
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