About the Role:

• We are looking for a detail-oriented individual to join our Care Access and Monitoring (CAM) team as a Data Entry Clerk.
• The primary responsibility of this role is to provide clerical and data entry support for Client Members who require hospitalization and/or utilization review for other healthcare services.

Responsibilities: -

• Enter information into the system from the fax system
• Verify eligibility and coverage
• Request missing information
• Redirect to in-network facilities
• Assist in phone queue questions
• Provide computer entries of authorization requests/provider inquiries by phone, mail, or fax
• Verify member eligibility and benefits
• Determine provider contracting status and appropriateness
• Assign billing codes
• Respond to requests for authorization of services
• Contact physician offices for missing information 
• Provide excellent customer service
• Notify Care Access and Monitoring Nurses and case managers of hospital admissions and changes in member status
• Meet productivity standards
• Maintain confidentiality and comply with HIPAA 
• Participate in team meetings

Education Qualification: -

• High School Graduate (CRP) - Some College

Required Skills: -

• Attention to detail
• Fast learner
• Ability to adapt to change
• Multi-tasking skills
• Strong communication skills
• Working knowledge of medical terminology and abbreviations
• Ability to problem solve
• Good interpersonal/team skills
• High regard for confidential information
• Ability to work in a fast-paced environment If you meet the qualifications and are looking to join a dynamic team in the healthcare industry, we encourage you to apply for this position.