Voice and Non Account
3 months ago
• Conduct utilization reviews to ensure patients receive appropriate care for their condition.
• Collaborate with medical staff on client diagnosis, treatment length, and documentation.
• Verify document completeness and request any necessary information for claims.
• Solve moderate to complex issues independently.
• Professionally interact with customers and healthcare providers to resolve inquiries.
• Gather feedback from patients regarding customer satisfaction
• Handle inbound and outbound calls from patients and healthcare providers
• Correspond with healthcare providers involved in primary care, nursing care and specialty care of patients to monitor progress and appropriateness of treatment
• Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
Qualifications:
o Bachelor of Science in Nursing GRADUATE
o Active PHRN License
o Amenable to work on night shift
o Strong knowledge of medical terminology
o Good Communication Skills both Oral and Written
o Strong ability to multitask, organize, and prioritize task
o Healthcare experience also be required
o Proficiency in MS Office
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