Telligen ยท 23 hours ago
Review Assistant II
West Des Moines, IA
Full-time
Hybrid
Entry Level
2+ years expTelligen is one of the most respected population health management organizations in the country, and they are seeking a Review Assistant II to support case review activities. The role involves managing inbound and outbound communication, ensuring data integrity, and providing quality customer service in a healthcare environment.
Health Care
No H1B
Responsibilities
You will interpret review guidelines to facilitate forward movement of the case review process including requests for clinical information, treatment plans, discharge dates and communicating the authorization for requested services
You will coordinate, distribute and track highly confidential medical information from multiple sources (fax, web, and phone)
You will interpret and adhere to URAC standards for assigned programs as well as federal and state requirements
You will ensure quality customer service by responding to phone inquiries from members, physicians, and providers. Prioritize workload to meet program or regulatory time frames
You will provide verbal and written communications of review decisions to include administrative denials
You will complete service/treatment screens for accurate transmission of outcome decision
You will provide general office support and perform miscellaneous duties as assigned
Qualification
Required
High school diploma or equivalent required
Minimum 2 years of experience working in a customer service or healthcare environment
Minimum 2 years of experience with data entry
Demonstrated ability to work with confidential information and maintain strict confidentiality
Proven ability to work effectively in a deadline-driven environment
Excellent written and verbal communication skills
Intermediate PC/computer skills
Ability to work independently with minimal supervision
Able to travel throughout the Des Moines metro area, reliable transportation required for local travel
Preferred
Experience in a health care environment preferred
Experience in Iowa Medicaid preferred
Experience in working remotely preferred
Satisfactory completion of medical terminology course preferred
Company
Telligen
Telligen is a trusted partner for U.S. government health agencies.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
RheaAnn Frost-Clewell
Vice President Finance & Administration/CFO
Brian Barry
Vice President - Enterprise Solutions & CIO
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