Curative · 1 day ago

Case Specialist

Austin, Texas Metropolitan Area

Full-time

Remote

Entry Level

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Responsibilities

Types, mails, and logs denial and appeal and complaint letters.

Generates reporting data for the health plans regarding denials, appeals and complaints on a monthly basis.

Maintains filing system for denials, appeals and complaints.

Accepts incoming calls and screens or resolves calls in accordance with plan design and authorization requirements.

Enters authorizations for services as delegated by assignment.

Runs and distributes reports from VBA data bases including authorization letters, daily authorization reports sent to health plans, and monthly statistical reports for management.

Creates and designs forms and reports as needed.

Maintains UM Committee minutes and updates UM Policy & Procedures as needed.

Assists supervisors with special projects as needed.

Performs other duties as assigned.

Maintains departmental data entry manual and edits content and updates format as needed.

Maintains files.

Provides desktop support to the department.

Qualification

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Microsoft AccessMedical terminologyWord processingSpreadsheet softwareClerical experience