Healthcare Administrator (Data Entry – Managed Care/Medicaid)
Bellaire, TX area
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
- 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.
- 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.
- Background check and drug screen required.
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