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Clinical Assistant

Chattanooga, TN 37402 | Fully Remote

Industry: Administrative/Clerical

Job Number: 187280

Pay Rate: $18-$25.50 per hour

Job Description

Remote with US, no 3rd party submissions, no C2C

Job Profile Summary

Supports customer service activities and initiatives for a number of 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 in to 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

Job Requirements

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 fast paced environment o Independent, Sound decision-making and problem-solving skills
• If current employee 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

Additional Information

HKA Enterprises is a global workforce solutions firm. If you’re seeking a new career opportunity or project experience, our recruiters will work to understand your qualifications, experience, and personal goals. At HKA, we recognize the importance of matching employee goals with those of the employer. We strive to seek credibility, satisfaction, and endorsement from all of our applicants. We invite you to take time and search for your next career experience with us! HKA is an EEO Employer who participates in the US Citizenship and Immigration Services E-Verify Program.

HKA Enterprises is a global workforce solutions firm. If you’re seeking a new career opportunity or project experience, our recruiters will work to understand your qualifications, experience, and personal goals. At HKA, we recognize the importance of matching employee goals with those of the employer. We strive to seek credibility, satisfaction, and endorsement from all of our applicants. We invite you to take time and search for your next career experience with us! HKA is an EEO Employer who participates in the US Citizenship and Immigration Services E-Verify Program.