Job Summary:
The Review Assistant role is pivotal in streamlining the clinical review process by meticulously preparing prior authorization cases. This individual will uphold a comprehensive understanding of internal policies, procedures, and services, ensuring adherence to organizational standards.
Responsibilities:
- Provide primary non-clinical program support by encompassing provider training, customer service, call triaging, authorization preparation, data entry, and the development and tracking of functions for members and providers
- Offer non-clinical support to other programs as needed, ensuring flexibility and adaptability in meeting organizational requirements
- Review patient records for completeness against submission requirements, identifying cases requiring additional non-clinical information
- Process and document case discharges with precision and timeliness
- Ensure accurate and prompt submission of all administrative-related documents to relevant parties
- Act as a liaison with internal and external customers, fostering positive and professional relationships to facilitate an effective review process
- Attend training and scheduled meetings, maintaining up-to-date information for case preparation
- Uphold medical records confidentiality through proper use of computer passwords and secured files, adhering to HIPAA policies
- Answer calls and demonstrate proper telephone etiquette and communication skills in alignment with Acentra Health's policies, procedures, and guidelines
- Cross-train to perform duties of other contracts within the Acentra Health network, contributing to a flexible workforce to meet client/consumer needs
- Fulfill other assigned duties to meet contract deliverables and organizational requirements
- Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules
Required Qualifications
- High school diploma or GED equivalent
- 1+ years of experience in administrative or records management
- 2+ years in an administrative support or customer service position and be familiar with health care
- Proficiency in Microsoft Office applications to include Excel
- Comprehensive knowledge of office environments and business processes
- Understanding of a customer service approach tailored for medical provider stakeholders
- Ability to multitask, prioritize, and provide service to a diverse range of customers
Preferred Qualifications
- Associate degree and/or equivalent work experiences related to medical, behavioral, or social/support settings preferred
- Familiarity with government structures and related programs is advantageous
- Experience in development and project activities
- Experience in staff and provider training, with preferred public speaking skills
- A proactive approach to continually assess office functions and report potential issues to the Director
- Capability to track provider issues and report them appropriately
- Willingness to learn the Atrezzo application
- Excellent communication skills
Pay Range: USD $13.97 - USD $17.20 /Hr
