*CANDIDATES MUST RESIDE IN OREGON or WASHINGTON STATE*
Innovative Care Management is seeking an experienced Precertification Specialist, residing within Oregon or Washington, to join our growing and dynamic team to provide customer service for precertification in a primarily telecommuting organization. The right candidate will have a working knowledge of medical terminology and possess exceptional customer service and telephone skills, as well as the ability to work remotely and to openly communicate and collaborate with all levels of the organization. A successful candidate will also possess strong computer skills and general comfort navigating various digital platforms to ensure success during remote training.
*This is a remote position, but we are only considering candidates that reside in Oregon or Washington State.*
Position Overview:
Under the general direction of the Manager, Precertification Programs, this position has overall responsibility for providing accurate and complete data input and application of non-clinical scripted criteria for precertification requests and providing excellent customer service. This position requires extensive use of the telephone (approximately 60% of the work week), extended sitting and long duration in front of a computer screen. Must be able to stay focused and engaged.
Position Requirements & Responsibilities:
- Answer calls from physician offices, hospitals, and patients using exemplary customer service skills.
- Accurately enter required information via phone, fax or email (non-clinical and structured clinical data) into computer database.
- Review structured clinical data, matching it against specified medical terms and diagnoses or procedure codes (without the need for interpretation) and follow established procedures for authorizing request or referring request for further review.
- Maintain patient confidentiality as defined by state, federal and company regulations.
- Responsible for answering a high volume of incoming calls to our busy phone lines.
- Attach incoming faxes to appropriate record in iCare and follow established procedures for distributing this information for further review.
- Notify providers with precertification numbers as needed and process completed precertification requests as per established procedures.
- Follow up on pending entry, requesting additional information to assist with medical reviews.
- Refer callers to benefit departments of correct claims administrator when requesting benefit information.
- Be logged in to the phone queue and available to take calls during scheduled times.
Schedule:
Monday-Friday 8:00 am-5:00pm Pacific Time. No evenings or weekends.
Work Experience and Qualifications Requirements:
- 1-2 years previous experience in medical office setting or working in precertification position providing customer service support required
- Strong knowledge of medical terminology.
- Strong time management, organization, attention to detail skills/abilities.
- Ability to problem solve/resolve emotionally charged situations or circumstances.
- Ability to work in a fully remote business setting without distraction or interruption.
- Strong oral and written communication skills — specifically telephone skills
- Strong focus on patient advocacy and empathy.
Preferred Qualifications:
- Insurance verification experience 1 year
- Customer service (in medical field) experience 1 year
- Call Center Experience
Education, Licensure, and Certification Requirements:
- High School Diploma or GED, required.
- Two years of college, preferred.
This is a work-from-home role performed almost exclusively from your home office with occasional in-person meetings and training. It’s important to have a private workspace free of distractions and responsibilities (pets, family, loud noises, etc.) during scheduled hours to set you up for success. We’ll provide all necessary computer equipment and a monthly monetary stipend for internet service.
You’ll need to provide internet service with a direct connection to a cable or fiber modem. Cellular and satellite connections are not acceptable. An internet speed test will be completed during the interview stage.
*All remote workers will be required to adhere to ICM’s Telecommuter Policy.*
Work and Physical Conditions:
- Ability to sit or stand for 8 hours per day.
- Ability to wear a headset, dial, answer, and talk on a telephone for 6-8 hours per day.
- Ability to sit or stand in front of a computer screen and type on a keyboard 8 hours per day.
- ICM is an alcohol and drug-free workplace and an EEO Employer. Offers are contingent on successful completion of drug and background screenings.
Job Type: Full-time
Pay: From $22.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Weekly day range:
- Monday to Friday
- No weekends
Application Question(s):
- Do you currently reside in Oregon or Washington State? Candidates for this position must reside in one of these two states.
Education:
- High school or equivalent (Required)
Experience:
- Medical terminology: 1 year (Required)
- Insurance Authorization: 1 year (Required)
- Certified Medical Assistant: 1 year (Preferred)
- Medical records: 1 year (Preferred)
- Customer service: 1 year (Required)
Location:
- Washington State (Required)
Ability to Relocate:
- Washington State: Relocate before starting work (Required)
Work Location: Remote