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Medical Case Specialist

CONFIDENTIAL Philadelphia ,PA
  • Posted: over a month ago
  • $12 to $14 Hourly
  • Temporary
Job Description

Job Summary:

Under limited supervision, performs a variety of activities in support of a specific project/business/technical unit. Gathers, collects, records, tracks and verifies data and information from multiple sources. Uses software for functional area to schedule appointments and document in the case management systems. Compiles and generate reports, statistics, timelines, tables, graphs, correspondence and presentations. Provides data and information to others on functional unit processes and procedures. Delivers exceptional customer service at all customer touch points.

Essential Duties and Responsibilities:

  • Answer phones from automated call distribution system
  • Triage daily download of referrals and ensure appropriate worksheets are assigned to corresponding conditions as identified by Veteran’s Administration
  • Verify appropriate CPT and CLIN codes are assigned to each case
  • Communicate directly with claimants and providers
  • Obtain medical history for specific conditions
  • Determine appropriate examinations, tests and specialists required for each case
  • Schedule appointments for examinees including follow-up appointments and rescheduled appointments
  • Ensure all examinees and providers receive necessary documentation
  • Confirm consultative reports and diagnostic test results are received in a timely manner
  • Meet or exceed contract timeliness guidelines in both the scheduling and case management systems
  • Other projects and duties as assigned

Competencies:

  • Proven ability to plan and organize work load
  • Ability to manage competing priorities in a fast paced work environment
  • Good follow through skills
  • Work well in a team oriented work environment
  • Strong verbal and written communication skills
  • Excellent customer service skills with ability to critically evaluate and resolve problems
  • Must possess the ability and flexibility to work early morning, evening, and/or weekend shifts

Education and/or Experience: (includes certificate & licenses)

· High School diploma, or equivalent (GED)

  • 0 to 1 year of related experience
  • healthcare experience preferred
  • Experience with electronic medical scheduling and case management software
  • Experience with medical coding and knowledge of medical terminology
  • Strong computer skills at intermediate level

· Must be able to successfully pass National Agency Check with Inquiries (NACI) background investigation

CONFIDENTIAL

Address

Philadelphia, PA
USA

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