Pacer Staffing LLC

Clinical Assistant

Pacer Staffing LLC United States
Pacer Staffing LLC

Clinical Assistant

Pacer Staffing LLC United States
3 weeks ago 57 applicants

See who Pacer Staffing LLC has hired for this role

Title: Clinical Assistant

Location: Remote

Duration: 3 months

Shift: 8:00am to 5:00pm

Job Qualifications

Education

  • High School Diploma or equivalent

Experience

  • 1 year - Customer service experience is required.

Skills\Certifications:

  • Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
  • Proficient oral and written communication skills
  • Proficient interpersonal and organizational skills
  • Exceptional time management skills
  • Ability to work independently under general supervision and collaboratively as part of a team in a challenging environment.
  • Independent, Sound decision-making and critical thinking skills
  • If a current employee is with the company, must meet minimum performance expectations.
  • Extensive knowledge of all aspects of Utilization Management, Care Management, and Behavioral Health.
  • Knowledge and understanding of medical terminology.
  • Solid knowledge and understanding of provider reimbursement methodologies, ICD-9-CM, CPT, HCPCS and UB-92 coding, UHDDS coding guidelines, AHA Coding Clinic
  • Ability to talk and type simultaneously in a clear and concise manner while interacting with customers.

Responsibilities

Job Profile Summary

  • Supports customer service activities and initiatives for several products or clients including but not limited to the Case Management and Utilization Management departments.

Job Responsibilities

  • Screen incoming calls and/or faxes or other digital format for UM and/or CM and direct calls/faxes/other digital requests to the appropriate area. Identify and refer cases appropriately to the Case Management and/or Transition of Care department.
  • Receiving, investigating and resolving customer inquiries and claims. Maintain departmental goals. Perform projects, review and handle reports as assigned.
  • Load complete organization determination/notification for services designed by internal policy. Clearly document and key data into the appropriate system using departmental guidelines.
  • Interact with membership, hospital and provider staff, advising of UM decision, status organization determinations, giving direction, as necessary.
  • Search for and key appropriate diagnosis and /or procedure code as part of the notification /prior authorization process.
  • Must be able to pass required testing.
  • Participation and attendance are mandatory.
  • This position requires flexibility, due to rotations in schedules, and requires adherence to assigned schedules.
  • Work overtime as required.

  • Seniority level

    Entry level

  • Employment type

    Full-time

  • Job function

    Health Care Provider

  • Industries

    Staffing and Recruiting

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