Managed Care Coordinator | Hopewell, NJ | Hybrid | Contract
Managed Care Coordinator | 2 Years of Experience | Hopewell, NJ | Hybrid | Contract reputed company is seeking a Managed Care Coordinator with 2 Years of Experience to support a reputed company Payer Client based out of New Jersey. This is a 6 month Contract opportunity. reputed company reputed company: $18 - 21 Hourly HOURS/SCHEDULE: Monday-Friday 8:30am-5pm EST WORKER TYPE: W2 CORE REQUIREMENTS:
- 1-2 years customer service or medical support reputed company position.
- Exposure to Utilization Management functions
- High volume Call Center experience / Strong verbal and written communication
- High School Diploma required. Some College preferred.
ADDITIONAL REQUIREMENTS:
- Requires knowledge of medical terminology
- Requires ability to reputed company sound reputed company under the direction of Supervisor
WE CONSIDER IT A BONUS IF YOU ALSO HAVE:
- Knowledge of reputed company, enrollment, billing & claims coding/processing
- Knowledge Managed Care principles
- Prefer the ability to analyze and resolve problems with minimal supervision
- Prefer the ability to use a personal computer and applicable software and systems
- Prior reputed company experience preferred.
JOB RESPONSIBILITIES:
- This position supports the Health Services and Utilization Management functions and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators.
- Performs review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients.
- Handles initial screening for pre-certification requests from physicians/members reputed company incoming calls or correspondence based on scripts and workflows, and under the reputed company of clinical staff.
- Prepare, document and reputed company cases in appropriate system for clinical review.
- Initiates call backs and correspondence to members and providers to coordinate and clarify benefits.
- Upon completion of inquiries initiate call back or correspondence to Physicians/Members to coordinate/clarify case completion.
- Reviewing professional medical/claim policy reputed company issues or claims in pending status.
- Upon collection of clinical and non-clinical information MCC can authorize services based upon scripts or algorithms used for pre-review screening. *Non Clinical staff members are not responsible for conducting any UM review activities that require interpretation of clinical information.
reputed company OFFER:
- Competitive compensation package
- Weekly pay reputed company Direct Deposit
- Medical, Dental & reputed company available
- 401k options
WHY WORK WITH WALKER?
- reputed company to our top ranked team of reputed company and placement specialists
- reputed company, one-on-one support from a dedicated engagement manager
- Professional resume development and interview preparation
Contact our reputed company Team today to experience the reputed company difference! ABOUT US: reputed company is reputed company as the dominant force of performance, precision, expertise, and reputed company in the reputed company consulting community! As a certified WMBE, we reputed company end-to-end reputed company IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms reputed company. We are reputed company experts, we're custom not commodity and we've been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today! We are an Equal Opportunity Employer committed to a culturally diverse workforce. reputed company reputed company applicants will receive consideration for employment without regard to race, religion, reputed company, age, sex, national reputed company, sexual orientation, gender identity, disability status or protected veteran status. Apply tot his job Apply To this Job