compensation: $18.74 to $23.28 DOE and Benefits options employment type: contract
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Our utilization review teams conduct medical necessity reviews a variety of medical, dental, and other healthcare services under Medicaid. You would support them by:
1. Helping providers to submit documentation of requests for case management, utilization review, and other medical management services.
2. Loading cases submitted via the web, fax, or phone into the care management system for clinical review.
3. Conveying case information and other notifications to providers via inbound and outbound phone calls.
4. Performing other duties as assigned.
We provide rigorous hands-on training, continuous feedback, and step-increases to production standards within a reasonable period of time.
Key abilities we seek include:
CSR- Productivity goal expectation ( 45)
• Reliability – You’d work an 8-hour day, Monday – Friday 8am – 5pm; we expect consistent adherence to this schedule and advance notice if you want time off or to start / end the day at a different time.
• Dependability – While working, we need you to focus on your assignments; personal needs should be addressed during scheduled breaks (except in rare, extreme circumstances).
• Customer focus – All interactions – internal and external, written and verbal – need to be approached with a willingness to help and remain pleasant, even under tense circumstances; treat others as you want to be treated.
• Flexibility – You could be in the midst of loading a case when your phone rings, so you’d pend the case, take the call, and upon the call’s conclusion resume the prior task; we expect to see the ability to shift priorities as needed, and whenever possible anticipate others’ needs before they ask.
Skills-wise, individuals should possess strong WPM (with a low error rate) and at least basic proficiency with medical terminology plus diagnosis and/or procedure coding. Excel and MS Office testing required. DC residents strongly urged to apply!Metro accessible, long term contract we are seeking people who are available for a MINIMUM of ONE YEAR ONLY THIS IS VITAL
NRI is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, among other things, or status as a qualified individual with disability.
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