[Remote] Review Assistant - SCA (Remote)

Note: The job is a remote job and is open to candidates in USA. Acentra Health is dedicated to empowering better health outcomes through technology and clinical expertise. They are seeking a Review Assistant to streamline the clinical review process by preparing prior authorization cases and ensuring adherence to organizational standards.

Responsibilities

• Provide primary non-clinical program support by encompassing provider training, customer service, call triaging, authorization preparation, data entry, and the development and tracking of functions for members and providers
• Offer non-clinical support to other programs as needed, ensuring flexibility and adaptability in meeting organizational requirements
• Review patient records for completeness against submission requirements, identifying cases requiring additional non-clinical information
• Process and document case discharges with precision and timeliness
• Ensure accurate and prompt submission of all administrative-related documents to relevant parties
• Act as a liaison with internal and external customers, fostering positive and professional relationships to facilitate an effective review process
• Attend training and scheduled meetings, maintaining up-to-date information for case preparation
• Uphold medical records confidentiality through proper use of computer passwords and secured files, adhering to HIPAA policies
• Answer calls and demonstrate proper telephone etiquette and communication skills in alignment with Acentra Health's policies, procedures, and guidelines
• Cross-train to perform duties of other contracts within the Acentra Health network, contributing to a flexible workforce to meet client/consumer needs
• Fulfill other assigned duties to meet contract deliverables and organizational requirements
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules

Skills

• High school diploma or GED equivalent
• 1-2 years of experience in administrative or records management
• 2-3 years in an administrative support or customer service position and be familiar with healthcare
• Comprehensive knowledge of office environments and business processes
• Associate degree preferred and/or equivalent work experience related to medical, behavioral, or social/support settings
• Understanding of a customer service approach tailored for medical provider stakeholders
• Familiarity with government structures and related programs is advantageous
• Excellent communication skills
• Ability to multitask, prioritize, and provide service to a diverse range of customers
• Experience in development and project activities
• Experience in staff and provider training, with preferred public speaking skills
• A proactive approach to continually assess office functions and report potential issues to the Director
• Capability to track provider issues and report them appropriately
• Willingness to learn the Atrezzo application and assist customers in resolving technical issues related to the submission of Health Homes authorization requests
• Proficiency in Microsoft Office applications and Excel, ensuring efficient utilization of essential software tools

Benefits

• Comprehensive health plans
• Paid time off
• Retirement savings
• Corporate wellness
• Educational assistance
• Corporate discounts

Company Overview