Role overview

Qualifications

High School Diploma
3 years experience in health care claims/service areas or office support
Two years’ experience in health care/managed care setting
Knowledge of CPT and ICD-10 coding

Responsibilities

Performs member or provider related administrative support
Reviews authorization requests for initial determination and/or triages for clinical review
Provides general support and coordination services for the department
Assists with reporting, data tracking, gathering, organization and dissemination of information

Key facts

Remote from: New York (USA)
Full time
Mid-level (2-5 years)
English

Hard skills

Medical Insurance Claims CPT Coding ICD Coding (ICD-9/ICD-10) Web Engineering

Other skills

Microsoft Office
Communication
Organizational Skills
Customer Service
Detail Oriented
Decision Making

About the company

ICONMA

Human Resources, Staffing & Recruiting

We provide Professional Staffing Services & Project-Based Solutions for a broad range of Fortune 500 organizations. ICONMA is a certified Woman-Owned staffing company and was founded in 2000. ICONMA’s corporate headquarters is in Troy, Michigan, and has 15+ locations worldwide. What makes ICONMA stand out in a fiercely competitive industry? *We provide integrated, full lifecycle services across a broad range of business and technical platforms. *No single company can duplicate our full range of staffing and permanent recruiting services nationwide. *Proven track record of attracting and retaining exceedingly skilled professional workers in a highly competitive market. SERVICES OFFERED Staff Augmentation (Contract, Contract to Hire, Direct Hire, Single Source) Data Analysis Project-Based Services & Solutions Hire Train Deploy Service Model Offshore Staff Augmentation Payroll Services AREAS OF EXPERTISE - Information Technology - Engineering - Business Professional - Accounting/Finance - Admin/Clerical/Call Center - Healthcare/Clinical/Scientific - Marketing/Creative mail linkedin@iconma.com Phone (888) 451-2519 Website http://www.iconma.com

Company details

Company typeLarge

IndustryHuman Resources, Staffing & Recruiting

Company size1001 - 5000

Links

Website LinkedIn See all jobs

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Job description

Our Client, a Health Insurance company, is looking for a Coord, Utilization Mgmt I for their Remote location.

Responsibilities:

35% Performs member or provider related administrative support which may include benefit verification, authorization creation and management, claims inquiries and case documentation.
35% Reviews authorization requests for initial determination and/or triages for clinical review and resolution.
20% Provides general support and coordination services for the department including but not limited to answering and responding to telephone calls, taking messages, letters and correspondence, researching information and assisting in solving problems.
10% Assists with reporting, data tracking, gathering, organization and dissemination of information such as Continuity of Care process and tracking of Peer to Peer reviews.

Requirements:

Education Level: High School Diploma
Experience: 3 years experience in health care claims/service areas or office support.
Preferred qualifications:
Two years’ experience in health care/managed care setting or previous work experience within division
Knowledge of CPT and ICD-10 coding.
Knowledge, skills and abilities (ksas):
Ability to effectively participate in a multi-disciplinary team including internal and external participants., Proficient
Excellent communication, organizational and customer service skills. , Proficient
Knowledge of basic medical terminology and concepts used in managed care., Proficient
Knowledge of standardized processes and procedures for evaluating medical support operations business practices., Proficient
Excellent independent judgment and decision-making skills, consistently demonstrating tact and diplomacy. , Proficient
Ability to pay attention to the minute details of a project or task, Proficient
Experienced in the use of web-based technology and Microsoft Office applications such as Word, Excel, and Power Point, Proficient
The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes them ineligible to perform work directly or indirectly on Federal health care programs.
Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Why Should You Apply?

Health Benefits
Referral Program
Excellent growth and advancement opportunities