Healthcare Administrator (Data Entry – Managed Care/Medicaid)

Healthcare Administrator (Data Entry –  Managed Care/Medicaid)

Bellaire, TX area

Overview:

USPRO is looking for a proven Administrative resource to work with a healthcare client of ours in the Bellaire, Texas area.

Employment type:  Contract

Duration:  4+ months

Responsibilities:

• Primarily responsible for processing initial incoming faxes or phone requests into the intake department.
• Gathering demographic and benefit data and documenting in appropriate system. This is determined through documented policy and procedures.
• Route and evaluate all calls and faxes to refer and assign as necessary to other staff.
• Perform data entry of authorization information into systems, and or fax information to, originating physician and or facility or specialist.
• Implement nuances of product line and regulatory requirements in the processing of all authorization requests including notification requirements.
• Responsible for confirming eligibility for requested authorizations and for requesting membership identification numbers for newborns.
• Utilize resources available from TCHP or State Agencies. Reference may be made by phone or online. Dates must be referenced prior to authorizations.
• Assist with complaint and appeal process regarding eligibility/claims and documents appropriately in the system.

Qualifications:

• Associates degree is preferred.
• Must have ability to operate PC, Windows, Word, fax machine, photocopier, computer and multi-line telephone.
• Excellent customer service skills and phone etiquette are required.
• Ability to handle high volume of calls, prioritize work, be flexible and perform as member of a team is required.
• Experience with Managed Care, preferably in medical management department, claims and member service background helpful.
• Healthcare setting employment a plus. ICD and CPT coding skills preferred.

Additional Notes:

• Background check and drug screen required.