Case Fulfillment Coordinator
This job posting is no longer active.
Apply now and our proprietary system will quickly have you in front of a live recruiter.
The Opportunity
Description
We're looking for a Case Fulfillment Coordinator, working in Healthcare Systems and Services industry in Schertz, Texas, United States.- Is responsible for all administrative components of fulfillment workflow process for Utilization Review referrals
- Routes and coordinates all referrals for prior authorization, concurrent review and retrospective review within the Utilization Review industry
- Uses discretion and independent judgment in handling patient or physician received documents and routes to appropriate administrative/clinical staff
- Works directly with physician reviewers maintaining communication regarding daily administrative review tasks
- Guides physicians to complete time-sensitive deadlines
- Ensures compliance processes and procedures are adhered to for all state, federal and referral/intake regulatory requirement for Utilization Review
- Is responsible for administrative Quality Assurance component (i.e., templates, completed fields, spelling, grammar, etc.) following completion of physician review
- Complies with template standards for each client
- Communicates with Director of Operations any referrals falling outside of standardized process
- Ensures seamless transition of all completed reviews to end-facing client in a time sensitive manner
- Is the primary contact for receiving phone calls, managing incoming calls and communications with physician panel
- Ensures proper jurisdictional case requirements, specialty requirements and conflicts of interest are utilized
- Uses discretion and independent judgment in prioritizing the workflow of all referrals
- Uses discretion and independent judgment in organizing and assigning time sensitive due dates to all physician panel
- Is responsible for daily case load of a minimum of 75 cases daily
- Maintains and organizes all documentation logs regarding assigned physician reviewers
- Answers, screens and forwards incoming phone calls regarding Case Fulfillment, while providing basic information when needed
- Maintains security by following procedures and controlling access (HIPAA)
- Supports others in a team environment
- Maintains a positive attitude and outstanding customer service while assisting physicians and their offices telephonically
Our Client
Our client provides outsourcing, staffing, consulting and
workforce solutions. Hiring for Engineering,
Finance and Accounting, Healthcare, Human Resources, IT, Legal, Life Sciences, Manufacturing
and Logistics, Sales and Marketing and Administrative roles. For 60 years.
Via 5,000 offices in 39 countries.
Matching smart people with
great jobs. Putting to work
nearly 700,000 employees worldwide.
Helping people like you achieve your potential. Using
innovative technologies and passion for people to provide you the best
experience possible. Every single day.
Let this be your day.
Put their expertise to work for you.
You deserve it!
Experience Required for Your Success
- High school diploma or equivalent
- 1-3 years directly related experience in an office based professional setting
- Professional in appearance
- Must type with the above proficiency
- Professionally communicate orally and written
- Ability to multi-task and quickly adapt in a fast-paced environment
- Ability to handle difficult/irate callers in a friendly and professional manner
- Strong organizational skills
- Attention to detail
- Proficiency in English
- Exemplary planning and time management skills
- Ability to work in high pressure, deadline driven environment
- Ability to multitask and prioritize daily workload
- Discretion and confidentiality
- Demonstrated ability to problem solve complex, multifaceted, situations
- Ability to work via web-based portal applications
- Ability to be resourceful and proactive in dealing with issues that may arise by working with team and Director of Operations
What Do You Think?
Does your experience reflect what it takes to be successful in this role? Do the work and challenges get you excited about what's possible?
