Administrative Data Entry- Professional experience in the medical field

• **** Must be willing to work 9 am to 6 pm PST *****

Full-time positions only at this time.

Job description: Administrative and data entry role for the Utilization Review and Peer Review Department for Workers’ Compensation, Group Health & Disability; verifies and enters data in appropriate system(s); and provides general support to clinical staff, reviewing physicians, claims adjusters, and others in a team environment.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES
• Uploading referral forms
• Entering new referral data
• Verifying client requirements
• Coordinating with nurses, physicians and clients
• Assigning new referrals and completing referral procedures
• Assigning, triaging and monitoring cases for utilization review (UR)
• Responding to communications from providers, claims adjusters, patients, and others
• Placing outbound telephone calls to providers to schedule and facilitate review discussions
• Entering demographics and other information into claims or clinical management system and maintaining data integrity
• Obtaining all necessary information required for utilization review processing and case management from internal and external sources per policies and procedures
• Distributing incoming and outgoing correspondence, faxes, and mail; uploading review documents into paperless system as necessary
• General data entry, general data retrieval, general document and information retrieval, general business communication
• Participating in audits, accreditation, and other quality assurance functions
• Performing all job functions according to the related policies, procedures, instructions, laws, and regulations promulgated by the appropriate authority or the company
• Running reports
• Attending or assisting in training
• Supporting other units as needed
• Performing other duties as assigned
• Supporting the organization's quality program(s)

QUALIFICATIONS: High school diploma or equivalent.

Physical Activity
• Requires extended periods of sitting, phone work and data entry

Position Requirements
• High school diploma required, AA or BA degree preferred
• Possesses excellent customer service skills
• Ability to plan daily schedule and demonstrate good organizational skills
• Professional and effective communication skills, both verbal and written
• Competency in Microsoft Office, Excel, online database systems, and keyboarding
• Ability to work independently, analyze information and problem solve
• Good teamwork, organizational, decision making, and management skills
• Capable of multitasking and meeting timeframes
• Must be able to handle sensitive and confidential information with the highest degree of professionalism

Preferred Skills and Qualifications
• Previous professional experience in the medical field, healthcare, insurance claims, Workers’ Compensation, managed care, medical management, and/or utilization review
• Medical terminology
• Bill review experience
• **** Must be willing to work 9 am to 6 pm PST *****

Job Type: Full-time

Schedule:
• Monday to Friday

Application Question(s):
• Can you work 9 am PST to 6 pm PST?

Shift availability:
• Day Shift (Preferred)

Work Location: Remote

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