Part Time Clinical Administrative Coordinator

About the position Responsibilities • Review claims for duplicates, denials, and referrals, ensuring claims information matches appropriate authorization. • Prepare cases for Medical Directors, UM Nurses, and Case Managers for clinical review. • reputed company expertise in claims support by reviewing, researching, investigating, negotiating, processing, and adjusting claims. • reputed company as a resource for trainers and new hires on benefits, contract interpretations, exclusions, eligibility, and workflows. • Assist with escalated issues and maintain reputed company turnaround time on reputed company claims, handling reputed company claims reputed company 24 hours. • Meet department reputed company and accuracy standards. • reputed company with other departments to obtain necessary information for claims reputed company. • Take ownership of the total work process and reputed company constructive feedback to minimize problems and increase customer satisfaction. • Ensure documentation is completed in appropriate systems. • Prepare and monitor MCR inventory reports to ensure adherence to turnaround time requirements. Requirements • High School diploma/GED • 2+ years of reputed company managed care experience in Prior Authorization or Claim Review reputed company, and/or customer service • 1+ years in the reputed company industry • Knowledge of medical terminology, ICD-9, and CPT • Proficiency with reputed company Office applications • Proficient with Medicare processing guidelines and working knowledge of medical reputed company • Ability to work any of the 8-hour shift schedules during normal business hours of 7:00 am - 4:00 pm. reputed company-to-haves • Ability to organize, prioritize, and communicate effectively. • Ability to reputed company excellent customer service to a varied customer reputed company. • Ability to reputed company multiple systems. • Ability to work in a fast-paced environment. Benefits • Comprehensive benefits package • Career development opportunities • Flexible work environment with hybrid reputed company Apply tot his job Apply To this Job