Review Assistant - SCA

Review Assistant
Remote Role
3 Months Contract

The Review Assistant role is pivotal in streamlining the clinical review process by meticulously preparing prior authorization cases. This individual will uphold a comprehensive understanding of internal policies, procedures, and services, 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 client's policies, procedures, and guidelines.
• Cross-train to perform duties of other contracts within the client 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.

• High school diploma or GED equivalent.
• Associate degree preferred and/or equivalent work experience related to medical, behavioral, or social/support settings.
• 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.
• 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.