Case Coordinator (32227)

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    "description": "<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong>AllMed&nbsp;</strong>is looking for a detail-oriented<strong> Case Coordinator</strong> to join our team!</span></span></p>\n\n<p>&nbsp;</p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong>SUMMARY</strong></span></span></p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">The Case Coordinator is responsible for conducting high-volume outbound calls to healthcare providers and patients in support of case management operations. This role focuses on gathering timely information to facilitate turnaround times and support overall client service delivery.&nbsp;The ideal candidate is detail-oriented, professional on the phone, and comfortable navigating conversations with both clinical offices and patients. While the primary focus is outbound communication, this role offers the opportunity to expand into broader case support functions over time.&nbsp;</span></span></p>\n\n<p>&nbsp;</p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">The hours for this position are <strong>Monday through Friday 9:00 AM to 5:00 PM EST and 11:00 AM to 7:00 PM EST&nbsp;</strong></span></span></p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong>RESPONSIBILITIES:</strong></span></span></p>\n\n<ul>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Conduct outbound calls to physician offices, healthcare providers, and patient to obtain required clinical and administrative information.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Clearly communicate the purpose of the call and gather accurate, complete documentation needed for case processing</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Follow established call scripts and workflows</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Document all call interactions thoroughly and accurately within internal systems</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Performs quality assurance review of reports, correspondences, addendums, or supplemental reviews.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ensures clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ensures that all client instructions and specifications have been followed and that all questions have been addressed.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ensures each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ensure that the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately on the case report.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ensures the provider credentials and signature are adhered to the final report.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Identifies any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Assists in resolution of customer complaints and quality assurance issues as needed.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ensures all federal ERISA and/or state mandates are always adhered to.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Provides insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications.</span></span></li>\n\t<li><span style=\"display:block; 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    "qualifications": "<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong>EDUCATION AND/OR EXPERIENCE</strong></span></span></p>\n\n<ul>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">High school diploma or equivalent required. </span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">A minimum of two years clinical or related field experience, or equivalent combination of education and experience. </span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Knowledge of the insurance industry preferably claims management relative to one of more of the following categories: workers compensation, no-fault, liability, and/or disability.</span></span></li>\n</ul>\n\n<p><br />\n<span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong>QUALIFICATIONS</strong></span></span></p>\n\n<ul>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; Ability to compute rates and percentages.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be a qualified typist with a minimum of 40 W.P.M</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be able to operate a general computer, fax, copier, scanner, and telephone.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must possess excellent skills in English usage, grammar, punctuation and style.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ability to&nbsp;accurately follow instructions and respond to directions from&nbsp;upper management.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be able to work independently, prioritize work activities and use time efficiently.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be able to maintain confidentiality.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be able to demonstrate and promote a positive team-oriented environment.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be able to stay focused and concentrate under normal or heavy distractions.</span></span></li>\n</ul>\n\n<p>&nbsp;</p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong>About Us:</strong></span></span></p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">AllMed provides clinical decision making and utilization management solutions to leading payer and provider organizations. We work closely with your team toward a shared vision of healthcare that delivers the highest quality, values patient experience, and ensures both appropriate care and utilization of health-related services.</span></span></p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Our solutions are developed and delivered by experts&mdash;they are thoughtfully designed to integrate seamlessly into your organization and help you deliver the right care to the right patients at the right time.</span></span></p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong>AllMed&nbsp;offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.</strong></span></span></p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong>Equal Opportunity Employer - Minorities/Females/Disabled/Veterans</strong></span></span></p>\n",
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