Demo

Patient Care Representative

TIMESSQUARETECH NYC INC
Pennington, NJ Full Time
POSTED ON 2/7/2025
AVAILABLE BEFORE 4/7/2025

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.

Core Individual Contributor Competencies: Personal and professional attributes that are critical to successful performance for Individual Contributors: Customer Focus Accountable Learn Communicate

  • Strong organizational and multitasking skills

Job Type: Contract

Pay: $15.00 - $18.00 per hour

Expected hours: 40 per week

Schedule:

  • Monday to Friday

Experience:

  • Customer service: 2 years (Required)
  • Medical Terminology: 1 year (Required)

Work Location: In person

Salary : $15 - $18

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