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Managed Care Coordinator

Iconma

Hopewell, NJ

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JOB DETAILS
SALARY
$19.31–$20.68 Per Hour
SKILLS
Algorithms, Billing, Claims Coding, Claims Processing, Clinical Data, Clinical Data Collection, Clinical Information, Communication Skills, Customer Relations, Customer Support/Service, Health Insurance, Health Plan, High School Diploma, Maintenance Services, Managed Care, Medical Office Administration, Medical Terminology, Organizational Skills, PC Software, Presentation/Verbal Skills, Problem Solving Skills, Request for Information (RFI), Scripting (Scripting Languages), Structured Data, Writing Skills
LOCATION
Hopewell, NJ
POSTED
3 days ago
Our Client, a Health Insurance company, is looking for a Managed Care Coordinator for their Hopewell¸ NJ location.
 
Responsibilities:
  • Performs review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients.
  •  Handles initial screening for pre-certification requests from physicians/members via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff. Prepare, document and route cases in appropriate system for clinical review.
  • Initiates call backs and correspondence to members and providers to coordinate and clarify benefits.
  •  Upon completion of inquiries initiate call back or correspondence to Physicians/Members to coordinate/clarify case completion.
  • Reviewing professional medical/claim policy related issues or claims in pending status.
  • Upon collection of clinical and non-clinical information MCC can authorize services based upon scripts or algorithms used for pre-review screening.
  • Non Clinical staff members are not responsible for conducting any UM review activities that require interpretation of clinical information.
  • Perform other relevant tasks as assigned by Management.
 
Requirements:
  • Core Individual Contributor Competencies: Personal and professional attributes that are critical to successful performance for Individual Contributors: Customer Focus Accountable Learn Communicate
  • High School Diploma required. Some College preferred.
  • Prefer 1-2 years customer service or medical support related position.
  • Requires knowledge of medical terminology
  • Requires Good Oral and Written Communication skills
  • Requires ability to make sound decisions under the direction of Supervisor
  • Prefer knowledge of contracts, enrollment, billing & claims coding/processing
  • Prefer knowledge Managed Care principles
  • Prefer the ability to analyze and resolve problems with minimal supervision
  • Prefer the ability to use a personal computer and applicable software and systems
  • Team Player, Strong Analytical, Interpersonal Skills
 
Why Should You Apply?

About the Company

I

Iconma

ICONMA is a global information consulting management firm providing Professional Staffing Services and Project-Based Solutions for organizations in a broad range of industries.

  • Corporate Headquarters in Troy, Michigan; 20+ locations worldwide.
  • Certified Woman-Owned Business Enterprise (WBE); certified by Women’s Business Enterprise National Council, National Women Business Owners Corporation (NWBOC); and California Public Utilities Commission (CPUC).
  • Founded in 2000
  • 2000+ Employees

The company was founded on the principle that success is derived from delivering high quality service and resources in the most responsive, flexible, and innovative way. ICONMA invests in people and resources with a single goal: To provide our customers with the highest quality service in the most responsive manner. Through its network of offices, ICONMA provides the resources to help clients maintain their competitive advantage.

COMPANY SIZE
2,000 to 2,499 employees
INDUSTRY
Management Consulting Services
EMPLOYEE BENEFITS
401K, Employee Referral Program, Life Insurance
FOUNDED
2000
WEBSITE
https://www.iconma.com/

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