Exciting remote opportunity with a reputable HealthCare company in Medical claims.
This is a remote position but you must live in Delaware! **** Great benefits and room for growth!**** Job title: Program Coordinator 1 Pay: 22.00 an hr Hours: Mon – Fri 8 am to 5 pm Location: Delaware, Remote Required Skills: Medical Background, Customer Service, Managed Care environment.
Job Description
Research claims inquiry specific to the department and responsibility.
Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census.
Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties to include but not limited to, contact the member’s attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs.
Coordinate services with community-based organizations. Attend marketing and outreach meetings as directed to represent the plan. Produces and mails routine CM letters and program educational material.
Data enter assessments and authorizations into the system.
Performance Expectation/metrics
Performance expectations/metrics is 40 calls per day reaching out to the members assigned to the Program Coordinator I.
Metrics must be met weekly to meet the expectation that is set by the department.
About TEKsystems
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Industries
IT Services and IT Consulting
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