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Medical Coding Representative
Location:
Montego Bay
Description:
Primary duties may include, but are not limited to: Managing incoming calls or incoming post services claims work. Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. Obtains intake (demographic) information from caller. Conducts a thorough radius search in Provider Finder and follows up with provider on referrals given. Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for precertification and/or prior authorization. Verifies benefits and/or eligibility information. May act as liaison between Medical Management and internal departments. Responds to telephone and written inquiries from clients, providers and in-house departments. Conducts clinical screening process. Requirements: Requires high school diploma or equivalent; 1 year customer service experience in healthcare related setting and/or medical terminology training; or any combination of education and experience, which would provide an equivalent background. Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Company:
Segoso Caribbean
Posted:
May 15 on ApplicantPro, TalentPlusHire
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