Job Description:
• Conduct utilization reviews to ensure patients receive appropriate care for their condition.
• Collaborate with medical staff on client diagnosis, treatment length, and documentation.
• Solve moderate to complex issues independently.
• Professionally interact with customers and health care providers to resolve inquiries.
• Gather feedback from patients regarding customer satisfaction
• Handle inbound and outbound calls from patients and healthcare providers
• Correspond with healthcare providers involved in primary care, nursing care and specialty care of patients to monitor progress and appropriateness of treatment
• Manage appointment bookings, cancellations, and rescheduling for patients and healthcare providers.
• Update and manage electronic health records (EHR)/EMR
• Respond to incoming patient inquiries, providing information and directing them to the appropriate healthcare professional.
• Coordinate the sending of medical records to various departments, healthcare providers, and professionals as directed by the Managing Physician.
• Prepare and send reports, letters, and other necessary documents
• Coordinate with labs, pharmacies, and other healthcare providers for patient needs
• Ensure HIPAA compliance, privacy regulations, and maintenance of patient confidentiality.
Qualifications:
• Bachelor's degree in medical fields or the pharmaceutical-related industry or at least 1 year of experience working in a healthcare account or related role
• Amenable to work on night shift
• Strong knowledge of medical terminology and procedures
• Excellent communication and organizational skills
• Strong ability to multitask, organize, and prioritize task
• Proficiency in MS Office and EHR/EMR systems and ability to troubleshoot common technical issues
• Tech savvy & familiar with current technologies, like desktop sharing, cloud services, and VoIP
• Comfortable in a fast-paced environment with a focus on continuous improvement.
• Health Insurance Portability and Accountability Act(HIPAA)