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Temporary Bill Processing Jobs Near Me

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Forklift Driver

Grove City, OH · On-site

$20/hr

These temp-to-hire opportunities will allow you to enhance your career while gaining valuable ... Handle bill of ladings and complete paperwork process Requirements of the Equipment Operator ...

Acloché LLC

Forklift Operator

Grove City, OH · On-site

$20/hr

These temp-to-hire opportunities will allow you to enhance your career while gaining valuable ... Handle bill of ladings and complete paperwork process Requirements of the Equipment Operator ...

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Care Review Processor I

Columbus, OH • On-site

Integrated Resources
Recruiting and Staffing Services • 51 - 200 employees
Learn more about Integrated Resourcesexternal

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Job description

Care Review Processor I

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.

Job Description

Title: Care Review Processor

Location: Columbus, OH

Duration: 3+ Months

Responsibilities:

  • Temp for 90 days, no possibility of going permanent.
  • M-F 8 am to 5 pm, no OT.
  • Building case prior authorization requests for members.
  • Heavy data entry and making phone calls out to doctors, hospitals, etc.
  • Medical background, prior authorization experience.
  • A minimum of 1-2 years' experience.
  • Knowledge of ICD 10 codes or CPT codes
  • Computer literate
  • Strong customer service skills with pleasant phone voice
  • Microsoft Excel (beginner level)
  • Works within the Care Access and Monitoring (CAM) team to provide clerical and data entry support for Members that require hospitalization and/or utilization review for other healthcare services.
  • Checks eligibility and verifies benefits, obtains and enters data into systems, processes requests, and triages members and information to the appropriate Health Care Services staff to ensure the delivery of high quality, cost-effective healthcare services according to State and Federal requirements to achieve optimal outcomes for Members.

    • Essential Functions:

    • Provide computer entries of authorization request/provider inquiries by phone, mail, or fax.
    • Including: verify member eligibility and benefits, determine provider contracting status and appropriateness, determine diagnosis and treatment request assign billing codes (ICD-9/ICD-10 and/or CPT/HCPC codes), Determine COB status.
    • Verify inpatient hospital census-admits and discharges.
    • Perform action required per protocol using the appropriate Database.
    • Respond to requests for authorization of services submitted to CAM via phone, fax and mail according to operational timeframes.
    • Participates in interdepartmental integration and collaboration to enhance the continuity of care for members including Behavioural Health and Long Term Care.
    • Contact physician offices according to Department guidelines to request missing information from authorization requests or for additional information as requested by the Medical Director.
    • Provide excellent customer service for internal and external customers.
    • Meet department quality standards, including inter-rater reliability (IRR) testing and quality review audit scores.
    • 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 Health Insurance Portability and Accountability Act (HIPAA). Participate in Care Access and Monitoring meetings as an active member of the team.
    • Meet attendance guidelines per Healthcare policy.
    • Follow standards of conduct guidelines as described in Healthcare HR policy.
    • Comply with required workplace safety standards.

    Knowledge/Skills/Abilities :

    • Demonstrated ability to communicate, problem solve, and work effectively with people.
    • Working knowledge of medical terminology and abbreviations.
    • Ability to think analytically and to problem solve.
    • Good communication and interpersonal/team skills.
    • Must have a high regard for confidential information.
    • Ability to work in a fast paced environment.
    • Able to work independently and as part of a team.
    • Computer skills and experienced user of Microsoft Office software.
    • Accurate data entry at 40 WPM minimum.

    Required Education:

    • High School Diploma/GED Required
    • Experience: 0-2 years of experience in a Utilization Review Department in a Managed Care Environment. Previous Hospital or Healthcare clerical, audit or billing experience.
    Qualifications

    High School Diploma/GED Required

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About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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