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paycor

Case Review Representative

OncoHealth
USA
Full-time
Entry · 2+ years experience
Hybrid
Discovered 1 months ago

Full Job Posting

  • Flexible to work rotational shifts inside our office hours from 8:00 a.m. – 8:00 p.m. EST to cover the operational needs of the company. Shifts can range anywhere between Monday – Friday 8:00 am to 8:00 pm EST and Saturdays 8:30 am - 5:00 pm EST (Office hours may change/extend upon operational needs)
  • Fax intake and labeling
  • Prior authorization creation
  • Quality Performance Program Outreach when assigned
  • Triage and manage inbound calls, routing case specific calls to an appropriate team member, and resolving tier 1 level issues
  • Triage and manage inbound emails from health plan clients, routing case specific emails to an appropriate team member, and resolving tier 1 level issues
  • Triage request/claims processing issues to health plans as needed Prior authorization creation
  • Quality Performance Program Outreach when assigned
  • College degree or relevant experience preferred
  • Fully Bilingual (English and Spanish)
  • Remote/hybrid work experience preferred
  • A minimum of 2 years of administrative experience and/or customer service or relevant educational attainment required
  • Skills for implementation of systems for program effectiveness and productivity required
  • Systems/Tools: MS Office Suite proficient

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