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Health Care Review Processor

Location : Columbus, OH
Job Type : Contract
Reference Code : 24069
Hours : Full Time
Required Years of Experience : 2+
Required Education : HS diploma or equivalent
Travel : No
Relocation : No

Job Description :

Major healthcare organization has an exciting opportunity for a contracted Care Review Processor to work with their office in Columbus, OH.  




 


This is a contract position currently budgeted at 3 months (potential for contract extension or a direct hire based on performance) and offers a starting pay rate of $17/hour. 


 


 


This is a Hybrid Schedule position (will work on site in Columbus 2 days/week and from home 3 days/week). 


 


 


Summary


 


The Care Review Processor 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. 




the Processor 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 their Members. 






 














Required Qualifications :

Qualifications




Required Education



  • High School or GED


 


Experience



  • Up to 2 years of experience in a Utilization Review Department in a Managed Care Environment strongly preferred




  • Up to 2 years of high volume previous data entry team experience required




  • Previous Hospital or Healthcare clerical, audit or billing experience. 



  • Experience with Medical Terminology.


 


 


Knowledge/Skills/Abilities



  • Strong typing skills are a must (40 WPM Minimum), as they are needed to keep up with the volume and pace. This is not just a data entry position. 



  • The ability to think critically and make decisions based on very little info is a frequent and critical job function.



  • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)



  • Working knowledge of medical terminology and abbreviations as well as billing codes (ICD-9/ICD-10 and/or CPT/HCPC codes)



  • Computer skills and experienced user of Microsoft Office software






 




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* Your eligibility for benefits depends upon your placement, hours billed and length of service. Your recruiter can identify the programs for which you are eligible. The Company reserves the right to modify or eliminate any of its non-legally mandated benefits at any time.