Job Openings
Remote Clinical Assistant
About the job Remote Clinical Assistant
Clinical Assistant needs 2 plus years of experience into customer service, medical terminology, and history with medical related jobs.
Clinical Assistant requires:
- High School Diploma or equivalent Experience
- COVID vaccinated maybe required
- 1 year - Customer service experience is required Skills\Certifications
- Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
- Proficient oral and written communication skills o Proficient interpersonal and organizational skills o 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-9-CM, CPT, HCPCS and UB-92 coding, UHDDS coding guidelines, AHA Coding Clinic
- Ability to talk and type simultaneously in a clear and concise manner while interacting with customers
- Participation and attendance are mandatory.
- Requires flexibility, due to rotations in schedules, and requires adherence to assigned schedules.
Clinical Assistant duties:
- Screen incoming calls and/or faxes or other digital format 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.
- Receive, investigate and resolve 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 in to the appropriate system using departmental guidelines.
- Interact with membership, hospital and provider staff, advising of decision, status organization determinations, giving direction as necessary.
- Search for and key appropriate diagnosis and /or procedure code as part of the notification /prior authorization process.
- Must be able to pass required testing.