Medical Documents Administrator - REMOTE - ref. m69251303

If you thrive in a fast-paced environment and have a strong understanding of medical records and health insurance, we want to hear from you!

What You'll Do:

• Document Processing: Prepare inbound faxes for coordinator processing, meticulously reviewing content and editing labels to ensure accurate document classification.
• Service Level Agreement (SLA) Management: Analyze SLA grids to determine appropriate turnaround times (TAT) based on health plan, product type, line of business, code, and priority. Accurately calculate and document TAT.
• Fax Management: Monitor the failed fax dashboard, identify transmission errors, and coordinate the re-sending of correspondence through appropriate channels.
• Email Management: Oversee and respond to requests in a shared email inbox, retrieving requested clinical documents and attaching them for timely case review.
• Administrative Support: Assist with additional administrative tasks, demonstrating flexibility and adaptability to evolving department needs.
• Performance Metrics: Meet established UM Intake Objective and Key Results.

What You'll Need:

• High school diploma or GED (Required).
• 1-3 years of experience in a population management, managed care/insurance, or hospital medical management department setting (Required).
• Basic knowledge of medical records with the ability to locate and verify member details (Required).
• Familiarity with health insurance lines of business (Commercial, Medicare, Medicaid) (Required).
• Working knowledge of medical coding systems (CPT/HCPCS) (Required).
• Ability to adapt to fluctuating situations and perform detailed work (Required).
• Proficiency in Microsoft Office Suite (Outlook, Word, Excel, OneNote) (Required).
• Team-oriented with a strong work ethic (Required).
• Demonstrated ability to meet goals in a remote environment (Preferred).
• Cable or Fiber internet connection. No wifi. Must be able to use ethernet cord. (Required)

INTERESTED IN LEARNING MORE? APPLY NOW! FOR MORE IMMEDIATE CONSIDERATION, email a current resume to iris.levy@randstadusa.com TXT: Your NAME and MEDICAL to 954-308-6735

education: High School

• A high school diploma or GED. (Required)
• 1 – 3 years of experience in a population management or managed care/insurance or hospital medical management department setting. (Required)
• Basic knowledge of medical records with the ability to locate and verify member details. (Required)
• Familiarity with health insurance lines of business (Commercial, Medicare, Medicaid) to correctly identify and classify incoming documents based on plan type. (Required)
• Working knowledge of medical coding system including CPT/HCPCS codes to differentiate between medical and pharmacy prior authorization requests. (Required)
• Ability to adapt to fluctuating situations and perform work of a detailed nature, while avoiding errors. (Required)
• Proficient using computer and Windows PC applications (Outlook, Word, Excel and OneNote), which includes strong keyboard and navigation skills. (Required)
• Team oriented, demonstrates a strong work ethic and committed to productivity. (Required)
• Demonstrated ability meeting established goals while balancing a workload and prioritizing assignments in a remote environment. (Preferred)

THIS IS 100% REMOTE - WORKING CENTRAL TIME ZONE HOURS -

Training Schedule - 8:30am-5pm CST / 40 hours per week Monday-Friday Shift Schedule after training - Monday - Friday, 9am-6pm CST / 40 hours per week

MUST BE ABLE TO HARD WIRE YOUR COMPUTER TO YOUR ROUTER/MODEM. MUST HAVE CABLE OR FIBER INTERNET. NO WI-FI ALLOWED.

ABSOLUTELY NO TIME OFF ALLOWED FOR THE FIRST 5 WEEKS.

• Medical Terminology
• managed care/insurance
• health insurance (1 year of experience is required)
• medical coding (1 year of experience is required)
• CPT Codes (2 years of experience is required)
• HCPCS

• Years of experience: 2 years
• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.