Job Description

Job Description

Job Description

Description:

Job Summary

This position is responsible for assigning and collecting cases completed by outside contractors through a secure FTP site; printing, organizing, and preparing cases for off-site medical contract reviewers; logging cases into a database and ensuring the correct due date and time are assigned to cases; communicating with all the contract reviewers via phone, text messaging, or email in order to assign and inform of due times; scanning, archiving, and modifying file names for all cases received from bookkeeping.

Essential Job Functions

• Receive Peer Reviews & Complex/Chart Reviews via email for assigned medical cases
• Print and organize cases
• Use logic and reasoning to determine whether a case will be accepted by the company
• Use logic and reasoning to chronologically determine and organize cases, assigning sensitive due datesand times
• Use logic and reasoning to determine the contract reviewer due date and time.
• Ensure cases are submitted to contract reviewers by the due date and time requested
• Have excellent time management skills to ensure time sensitive material is prioritized and processed andbe able to self-organize the priority of cases
• Use logic and reasoning to determine and assign fees for charged services
• Use logic and reasoning to determine the payable amount to each contract reviewer
• Track and organize cases assigned to contract reviewers through Excel
• Navigate a secure FTP site to assign cases and pick up completed cases
• Communicate routinely with Operations Manager regarding cases that are out for review
• Archive scanning of case files after the Billing process
• Maintain confidentiality
• Effectively work with all team members and vendors (both orally and in writing)

Knowledge and Abilities Requirements:

• Utilize a computer, printer, and telephone for business purposes
• General Typing Skills at 65wpm; Data Entry 10 Key Skills at 5,000kph / Data Entry Alpha Numeric Skills at 10,000kph
• Knowledge of Microsoft Office 2003 (or more recent)
• Proficiency in Excel
• Ability to work in a fast paced environment and support others in a team environment
• Ability to follow organizational work flow

Education and Experience:

High school diploma or equivalent; prior experience in a fast paced office setting.

License and Certification: None

Driving Essential: No

Equal Employment Opportunity (Our EEO Statement)

The Company is a veteran-owned Company and provides Equal Employment Opportunities (EEO) to all Team Members and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender (including gender identity), pregnancy, childbirth, or a medical condition related to pregnancy or childbirth, national origin, age, disability, genetic information, status as a covered veteran in accordance with applicable federal, state, and local laws, or any other characteristic or class protected by law and is committed to providing equal employment opportunities. The Company complies with applicable state and local laws governing non-discrimination in employment. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, promotion, discharge, pay, fringe benefits, membership, job training, classification, and other aspects of employment. Team Members who believe they are the victims of discrimination should immediately report the concern to their Supervisor and Human Resources Department. Discrimination and harassment will not be tolerated.

We are committed to creating an inclusive environment for all Team Members and applicants. We value the unique skills and experiences that veterans bring to our team and encourage veterans to apply.

Position Demands: This position requires sitting, bending, stooping for up to 8 hours per day in an office setting. Ability to lift and

move objects weighing up to 10 lbs. Ability to learn technical material. The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc. Must be able to operate a computer and other office productivity machinery such as a calculator, copy machine, printer, etc. The person in this position frequently communicates with guests, team members, and vendors and must be able to exchange accurate information.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of our personnel. All team members may be required to perform duties outside of their normal responsibilities from time to time, as needed.

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