Hiring For Medical Coordinator!

100% REMOTE

Note: Candidates from McAllen Texas can only apply!

Candidates who are having 2+yrs of experience in Medical field can only apply!

Description:

Position Purpose:

Supports the prior authorization request to ensure all authorization requests are addressed properly and in the contractual timeline. Aids utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access.

• Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility.

• Perform tasks necessary to promote member compliance such as verifying appointments obtaining lab results. Assess and monitor inpatient census.

• Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management CM assessment. Perform transition of care duties to include but not limited to contact the members attending physician member or medical power of attorney other medical providers home health agencies equipment vendors for information pertaining to special needs.

• Coordinate services with community based organizations. Attend marketing and outreach meetings as directed to represent the plan. Produces and mails routine CM letters and program educational material.

• Data enter assessments and authorizations into the system.

Skills:

medical terminology

Additional Skills & Qualifications:

ducation/Experience: High school diploma or equivalent. 2-3 years managed care setting medical office or facility setting with demonstration of medical administration duties. Thorough knowledge of customer service utilization review or claims processing practices in a managed care environment and operation of office equipment such as a personal computer. Knowledge of medical terminology.

Experience Level:

Entry Level

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.