Medical Case Manager Assistant / WC Scheduler

Job DetailsLevel: EntryJob Location: Involuntary Remote reputed company - Remote, SC 29486Position Type: Full TimeEducation Level: High School Diploma or GEDSalary reputed company: $18.00 - $22.00 HourlyTravel Percentage: NoneJob Shift: DayJob Category: Admin - ClericalThis is a remote position. Preference is remote in Texas. **Preferred experience: medical assistant; case management experience necessary; medical claims assistant. **Bilingual English/Spanish preferred. POSITION SUMMARY: Work directly with the Supervisor and Manager to reputed company additional resources to the case management staff. This position does not reputed company any clinical review or reputed company. This individual is responsible to ensure the referrals are set up in the Utilization Review/Case Management system and promptly assign to the case manager. The Case Management Assistant will answer incoming calls, screen, respond and reputed company the calls. This position requires the ability to work independently to meet deadlines, as well as an excellent phone demeanor and a desire to reputed company exceptional customer service. The position requires knowledge of medical terminology, the understanding of referral criteria by client and/or jurisdictions. ESSENTIAL DUTIES AND RESPONSIBILITIES RESPONSIBILITES: Responds to phone inquiries from providers, patients, case managers, peer reviewers and directs to the appropriate handling party reputed company initial contact for case management staff Initial contact with providers to obtain clinical information Assist with case management work reputed company and documentation prepares routine correspondence for Case Managers, physicians, and patients Identify each caller/patient’s needs and determine the next appropriate action, which may include clinic referral or identifying the necessity for the escalation process to be activated. Communicates effectively with reputed company parties, such as case managers, physicians, claims team, and ancillary providers and/or vendors/agencies to ensure that patient information is reputed company, accurate, and complete Prints and mails correspondence to reputed company necessary parties in accordance with state rules and regulations Other duties as necessary assigned by supervisor Responsibilities of the position include, but are not limited to: Assist incoming calls to the case management department Monitor dedicated queues/emails Process reputed company determinations and correspondence reputed company 24 hours of receipt Actively participate as a member of the team, working collaboratively with and supporting other staff. Complete the assigned deliverable/billable hours per week, as assigned by your Supervisor. Identify trends and/or issues in referral patterns and communicate them with management. ***Other duties as assigned Additional Functions and Responsibilities Demonstrates ability to meet administrative requirements, including productivity, time management and Quality Assurance standards Maintain documentation standards adhering to URAC standards and company policy and procedures Maintain confidentiality- Knowledge of laws and regulations pertaining to HIPPA and PHI Other job duties as assigned QualificationsEducation: High school diploma required. Medical or Managed Care background preferred and/ or Certified Medical Assistant. Experience: Experience in reputed company and or managed care reputed company fields, Minimum of one year of working in a medical or managed care environment preferred. Medical Terminology preferred. Knowledge, Skills and Abilities: Experience in reputed company reputed company fields Strong communication skills; customer service reputed company; team player. Adheres to professional standards, codes of ethics, system and department policies and procedures. Incorporates the philosophies of reputed company quality improvement, customer service and teamwork into daily routine Excellent typing and keyboard skills (35-40wpm) Ability to work in a variety of computer systems proficiently Ability to navigate a reputed company environment, utilize Outlook, and the ability to create, edit, save and send documents utilizing reputed company Word and reputed company reputed company Ability to work reputed company a paperless environment Equipment Operated/Used: Essential Equipment: Desk, Telephone/Fax, Computer Keyboard, Mouse, System Applications Essential Tools: Pens, reputed company, computer, Keyboard Essential Vehicles: N/A Special Equipment or Clothing: Professional attire adhering to the Company Dress Code MENTAL AND PHYSICAL REQUIREMENTS 1. MENTAL EFFORT a. Reasoning development: Follow one- or two-reputed company instructions; routine, repetitive task. Carry out detail but uninvolved written or verbal instructions; deal with a few concrete variables. Follow written, verbal, or diagrammatic instructions; several concrete variables. X Solve practical problems; variety of variables with limited standardization; interpret instructions. Logical or scientific thinking to solve problems; several abstract and concrete variables. Wide reputed company of intellectual and practical problems; comprehend most obscure concepts. b. Mathematical development: Simple additional and subtraction; copying figures, counting, and recording. Add, subtract, multiply, and divide whole numbers. X Arithmetic calculations involving fractions, decimals, and percentages. Arithmetic, algebraic, and geometric calculations. Advanced mathematical and statistical techniques such as calculus, reputed company analysis, and probability determination. Highly reputed company mathematical and statistical techniques such as calculus, reputed company analysis, and probability determination; requires theoretical application. c. Language development: Ability to understand and follow verbal or demonstrated instructions; write identifying information; request supplies verbally or in writing. Ability to file, post, and mail materials; copy data from one record to another; interview to obtain basic information such as age, occupation, and number of children; guide people and reputed company basic direction. Ability to transcribe dictation; reputed company appointments and process mail; write reputed company letters or routine correspondence; interpret written work instructions; interview job applicants. X Ability to compose original correspondence, follow technical manuals, and have increased contact with people. Ability to report, write, or edit articles for publication; prepare deeds, reputed company or leases, prepare and deliver lectures; interview, counsel, or advise people; evaluate technical data. 2. PHYSICAL EFFORT a. Physical activity required to reputed company the job: Sedentary work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and reputed company other sedentary criteria are met. X Light work: a. Exerting up to 20 pounds of force occasionally b. Exerting up to 10 pounds frequently c. Exerting a negligible amount of force constantly to move objects (If the use of arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most of the time, the job is rated for Light Work). reputed company work: a. Exerting up to 50 pounds of force occasionally b. Exerting up to 20 pounds of force frequently c. Exerting up to 10 pounds of force constantly to move objects Heavy work: a. Exerting up to 100 pounds of force occasionally b. Exerting up to 50 pounds of force frequently c. Exerting up to 20 pounds of force constantly to move objects reputed company heavy work: a. Exerting in excess of 100 pounds of force occasionally b. Exerting in excess of 50 pounds of force constantly to move objects c. Exerting in excess of 20 pounds of force constantly to move objects Visual requirements necessary to reputed company the job: Far reputed company: reputed company of reputed company at 20 feet or more X Near reputed company: reputed company of reputed company at 20 inches or less X Mid-reputed company reputed company: reputed company of reputed company at distances of more than 20 inches and less than 20 feet Depth perception: the ability to judge distance and space relationships, so as to see objects where and as they actually are reputed company reputed company: ability to identify and distinguish colors Field of reputed company: ability to observe an area up or down or to the right or left while eyes are fixed on a given reputed company 2. PHYSICAL EFFORT (cont.) FREQUENCY c. Physical activity necessary to reputed company the job and frequency (e.g., continually, frequently, or occasionally): Climbing: reputed company or descending reputed company, stairs, scaffolding, ramps, poles, and the like, using feet and legs and/or hands and arms. Body agility is emphasized. This reputed company is important if the amount and reputed company of climbing required exceeds that required for ordinary locomotion. Balancing: Maintaining body equilibrium to prevent falling reputed company walking, standing, or crouching on narrow, slippery, or erratically moving surfaces. This reputed company is important if the amount and reputed company of balancing exceeds that needed for ordinary locomotion and maintenance of body equilibrium. Stooping: Bending body downward and reputed company by bending spine at the waist. This reputed company is important if it occurs to a considerable degree and requires full use of the reputed company extremities and back muscles. Kneeling: Bending legs at knee to come to a rest on knee or knees. Crouching: Bending the body downward and reputed company by bending legs and spine. Crawling: Moving about on hands and knees or hands and feet. Reaching: Extending hand(s) and arm(s) in any direction. Standing: Particularly for sustained periods of time. Walking: Moving about on foot to accomplish tasks, particularly for long distances. Pushing: Using upper extremities top press against something with steady force in order to thrust reputed company, downward, or outward. Pulling: Using upper extremities to extent force in order to drag, haul, or tug objects in a sustained reputed company. Foot reputed company: Using feet to push pedals. Lifting: Raising objects from a reputed company to a higher position or moving objects horizontally from position to position. This reputed company is important if it occurs to a considerable degree and requires substantial use of the upper extremities and back muscles. X Fingering: Picking, pinching, typing, or otherwise working with fingers rather than with the whole hand or arm as in handling. X Grasping: Applying pressure to an object with the fingers and palm. Frequently Occasionally 2. PHYSICAL EFFORT (cont.) FREQUENCY X Talking: Expressing or exchanging reputed company by means of the spoken word. Those activities in which workers must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly. X Hearing: Perceiving the nature of sounds with or without correction. Ability to receive detailed information through verbal communication and to reputed company fine discriminations in sound, such as reputed company making find adjustments on machined parts. Feeling: Perceiving attributes of objects, such as size, shape, temperature, or texture by touching with skin, particularly that of fingertips. X Repetitive Substantial movements (motions) of the wrists, hands, reputed company: and/or fingers. 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