Review Assistant

Acentra Health, LLC•UNAVAILABLE, UNAVAILABLE

1d•Remote

About The Position

The Review Assistant role is pivotal in supporting and streamlining the prior authorization and clinical review process. This individual is responsible for accurately preparing and processing various aspects of prior authorization cases to facilitate timely and efficient clinical review. The Review Assistant maintains a comprehensive understanding of applicable policies, procedures, workflows, and services to ensure consistency and adherence to organizational standards. Strong communication and interpersonal skills are essential, as the role requires clear and effective communication with internal teams, providers, and other stakeholders to obtain necessary information, address questions, and support the prior authorization process from intake through case disposition. Position is remote.

Requirements

High school diploma or GED equivalent.
A minimum of 2+ years of experience in records management.
A minimum of 2+ years in an administrative support or customer service position in a healthcare environment.
Experience working in Remote
Comprehensive knowledge of office environments and business processes.
Ability to multitask, prioritize, and provide service to a diverse range of customers.
Proficiency in Microsoft Office applications and Excel, ensuring efficient utilization of essential software tools.
Excellent communication skills.

Nice To Haves

Associate degree and/or equivalent work experience related to medical, behavioral, or social/support settings.
Understanding of a customer service approach tailored for medical provider stakeholders.
Familiarity with government structures and related programs is advantageous.
Experience in development and project Management activities.
A proactive approach to continually assess office functions and report potential issues to the Director.

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 requirement.
Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.