Job Title: Experienced Administrative Data Entry Professional – Medical Field Expertise for Utilization Review and Peer Review Department
Job Description:
About blithequark
At blithequark, we are committed to delivering exceptional healthcare services to our clients. Our Utilization Review and Peer Review Department plays a vital role in ensuring that our clients receive the best possible care. We are seeking an experienced Administrative Data Entry Professional to join our team and contribute to our mission of providing high-quality healthcare services.Job Summary
We are looking for a highly skilled and detail-oriented Administrative Data Entry Professional to support our Utilization Review and Peer Review Department. As a key member of our team, you will be responsible for verifying and entering data into our system, providing general support to clinical staff, and coordinating with nurses, physicians, and clients. If you have a passion for the medical field and excellent administrative skills, we encourage you to apply for this exciting opportunity.Essential Functions and Responsibilities
As an Administrative Data Entry Professional, you will be responsible for the following key tasks:- Uploading referral forms and entering new referral data into our system
- Verifying client requirements and coordinating with nurses, physicians, and clients
- Assigning new referrals and completing referral procedures
- Assigning, triaging, and monitoring cases for utilization review (UR)
- Responding to communications from providers, claims adjusters, patients, and others
- Placing outbound telephone calls to providers to schedule and facilitate review discussions
- Entering demographics and other information into claims or clinical management system and maintaining data integrity
- Obtaining all necessary information required for utilization review processing and case management from internal and external sources per policies and procedures
- Distributing incoming and outgoing correspondence, faxes, and mail; uploading review documents into paperless system as necessary
- General data entry, general data retrieval, general document and information retrieval, general business communication
- Participating in audits, accreditation, and other quality assurance functions
- Performing all job functions according to the related policies, procedures, instructions, laws, and regulations promulgated by the appropriate authority or the company
- Running reports
- Attending or assisting in training
- Supporting other units as needed
- Performing other duties as assigned
- Supporting the organization's quality program(s)
Qualifications
To be successful in this role, you will need to possess the following qualifications:- High school diploma or equivalent required; AA or BA degree preferred
- Excellent customer service skills
- Ability to plan daily schedule and demonstrate good organizational skills
- Professional and effective communication skills, both verbal and written
- Competency in Microsoft Office, Excel, online database systems, and keyboarding
- Ability to work independently, analyze information, and problem-solve
- Good teamwork, organizational, decision-making, and management skills
- Capable of multitasking and meeting timeframes
- Must be able to handle sensitive and confidential information with the highest degree of professionalism
Preferred Skills and Qualifications
While not required, the following skills and qualifications are highly desirable:- Previous professional experience in the medical field, healthcare, insurance claims, Workers' Compensation, managed care, medical management, and/or utilization review
- Medical terminology
- Bill review experience
Work Environment and Company Culture
As a remote employee of blithequark, you will have the flexibility to work from home and enjoy a comfortable and productive work environment. Our company culture values collaboration, innovation, and excellence, and we are committed to providing our employees with the tools and resources they need to succeed.Compensation, Perks, and Benefits
We offer a competitive salary and benefits package, including:- Competitive salary
- Health, dental, and vision insurance
- Retirement plan
- Flexible work arrangements
- Professional development opportunities
- Recognition and rewards for outstanding performance
Career Growth Opportunities and Learning Benefits
At blithequark, we are committed to helping our employees grow and develop their careers. We offer a range of training and development opportunities, including:- On-the-job training and mentorship
- Professional development courses and workshops
- Opportunities for advancement and promotion
- Access to industry-leading tools and technologies