Health Entry Coordinator (Remote)

MRIoA • Mountain View, CA

6d • Remote

About The Position

Founded in 1983, we’re a clinically-driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to healthcare organizations. Excellence starts with our people. Our Health Entry Coordinator is responsible for carrying out day-to-day departmental tasks and completing all processes for screening incoming review requests, preparing review information and materials for assignment to appropriate Reviewers and maintaining online case summary/tracking system information

Requirements

• Ability to work under pressure and meet deadlines while managing multiple high priorities
• Personal computer literacy and high competency in use of Microsoft Word, Microsoft Excel and Adobe
• Strong working knowledge of basic anatomy, physiology and medical terminology
• Strong detail orientation
• Strong organizational skills
• Strong oral and written communication skills
• Well-developed customer service and training skills
• Ability to work independently with minimal supervision
• Understanding and knowledge of company's clients, products, departments and workflows, and applicable regulatory requirements and accreditation standards
• Minimum of one year’s experience in similar operations
• Experience in health care, managed care or utilization management company
• High school diploma

Nice To Haves

• Preference for Bachelor's degree preferably in business or health care

Responsibilities

• To prepare high-quality, complete packets of appropriate case review information and materials for submission to the panel reviewers
• To serve as company liaison with clients, reviewers, and practitioners/providers/facilities whose services are subject to review
• Screen incoming review requests for completeness of materials required to conduct the review of the case
• Prepare, organize, distribute, and present records, materials, and forms required for a complete case review packet for Reviewers
• Identify appropriate Reviewers for case review assignment including (next two bullet points):
• Determine their availability for a review assignment; and
• Obtain information for delivery of the case to the reviewer, if applicable
• Contact clients to resolve questions, obtain information, records and/or materials needed for a case review and resolve issues about active cases
• Respond to reviewers’ requests for additional information/materials necessary for a review and notify clients and other internal departments of these needs, as applicable
• Coordinate and record phone consultations between Reviewers and practitioners/providers/facilities that are party to a review case
• Create and maintain an in-house review file for each active case
• Respond to inquiries from clients, other entities referring cases for review, and practitioners/providers/facilities
• Support all Quality Management initiatives
• Actively participate in the Complaint Process and Provider Relations assessment process
• Support all Compliance Program activities
• Provide backup support to staff in other areas as applicable
• Participate in all company meetings and committees as requested
• Maintain a flexible schedule to meet client needs
• Adhere to all policies and procedures
• Take feedback and responsibility for performance
• Adapt to differences of clients
• Complete other duties and responsibilities as directed

Benefits

• A competitive compensation package.
• Benefits include healthcare, vision and dental insurance, a generous 401k match, paid vacation, personal time, and holidays.
• Growth and training opportunities.
• A team atmosphere with fun events and prizes scheduled throughout the year.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 251-500 employees