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Admin Support Rep (Remote, $13.50/Hour)
Company | American Specialty Health |
Address | United States |
Employment type | FULL_TIME |
Salary | |
Category | Wellness and Fitness Services |
Expires | 2023-05-31 |
Posted at | 1 year ago |
Description
- Forwards faxed MNR Forms to the appropriate Clinical Quality Evaluation for review.
- Bundles MNR Forms and reports by teams.
- Call Providers and Members as required by the State.
- Runs MNRF queries in FoxPro.
- Systematically faxes MNR Response Forms (MNRF) to practitioner using Broadfax.
- Prepares fax files for Broadfax.
- Document all calls in the state required log screen.
- Ensure members are notified verbally in accordance with state regulations.
- Print and deliver file history as needed.
- Reprint MNR Forms that cannot be located.
- Removes the MNRFs that failed to be faxed from Broadfax and assists with manually mailing them to the practitioner.
- Fax and Mail MNRFs as needed.
- Checks with MNA staff to see if the Medical Necessity Review Form (MNR Form) is in house. If so, advises staff to process the MNR Form as priority.
- Removes data entry errors form the batch jobs and FoxPro.
- Ensures all MNR Forms are accounted for on the CQE Daily Report.
- Researches turn-around time utilizing the Medical Necessity In Process Report.
- Calls practitioner to request re-faxing of MNR Forms as necessary.
- Ensure providers are notified verbally in accordance with state regulations.
- Documents all phone calls in ASH proprietary system per MNA guidelines.
- Contacting practitioner on medical necessity determinations, as required by State Law.
- Processes a minimum of 100 state required calls per day.
- Prepares Medical Necessity Review Forms (MNR Forms).
- Runs a variety of Queries and Reports.
- Delivers MNR Forms and reports to CQE within standards.
- Minimum 2 years data entry experience and working knowledge of computers including word processing and spreadsheets. Internal experience at ASH preferred.
- Microsoft Word and Excel experience required. Experience with Microsoft Access highly desirable.
- High school diploma required.
- Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
- Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
- Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
- Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
- Ability to exercise strict confidentiality in all matters.
- Demonstrated accuracy and productivity in a changing environment with constant interruptions.
- Ability to effectively organize, prioritize, multi-task and manage time.
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