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 Apply Job! Apply tot his job Apply To this Job