Randstad Administrative Assistant in San Antonio, Texas
location:San Antonio, TX
salary:$14 per hour
date posted:Wednesday, February 6, 2019
industry:Administrative and Support Services
Contract: 02/04/2019 to 05/04/2019
Schedule: Monday to Friday 8am to 5pm
Pay rate: $14.00/hr
The Associate Patient Care Coordinator provides support to the UM department in administrative functions for UM organization determinations and appeal coordination. This position utilizes knowledge of Medicare and state HMO guidelines in order to facilitate and comply with the Utilization Management plan in data entry and to prepare letters utilizing standard templates. The Associate Patient Care Coordinator will also provide float coverage for the central UM department, utilizing and following established policies and procedures.
Working hours: 8:00 AM - 5:00 PM
Essential Job Functions
Provides data entry, filing, tracking time frames and status of case files and mailing letters to patients and providers.
Reviews denials and determines whether the decisions are retro/ claims DOS or prospective DOS, and whether they are NCB or medically necessary. Sorts appropriately.
Monitors system approval queues and prints member letters, ensuring that all approvals are printed and mailed by end of business day.
Prepares envelopes and letters for mailing according the UM policy.
Receives appeal requests from health plans and/ or QIO, logs requests, researches and provides requested information.
Works with claims department to redirect claims related appeal requests.
Generates reports for analysis by department using the data entry system.
Assists with CMS organization determination reports as needed
Minimum Required Education, Experience & Skills
High School diploma or GED required.
Two or more years of related experience.
Sound knowledge of medical terminology.
Proficient software computer skills.
Excellent verbal and written skills.
Possess planning, organizing, conflict resolution, negotiation and interpersonal skills.
Independent problem identification/resolution and decision making skills.
Ability to interact with individuals and with multidisciplinary teams.
Ability to demonstrate excellent customer service with patients, providers, and health plan and interacting with other internal departments within the organization.
Preferred Education, Experience & Skills
- Previous related experience in healthcare preferred.
Please apply online. Resumes may also be emailed to firstname.lastname@example.org with "Admin-SanAntonio" in the subject line. Thank you!
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