UM / Data Entry Tech

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          "text": "<p><b><span>Principal </span>Accountability<span>:</span></b><br /></p><p><b><span></span></b></p><ul><li><span>Screens information received and refers members to the appropriate provider and/or contacts the provider directly for members.</span></li></ul><ul><li><span>Facilitates the authorization process for requests that do not require clinical criteria application or judgment.</span></li></ul><ul><li><span>Provides relevant information to members and assists them in resolving Plan related problems when Member Services personnel are not available.</span></li></ul><ul><li><span>Acts as a resource to staff for questions related to the prior authorization process.</span></li></ul><ul><li><span>Refers unresolved prior authorization process questions to the Lead Intake Specialist.</span></li></ul><ul><li><span>Assists the Lead Intake Specialist in identifying, planning and implementing staff training programs.</span></li></ul><ul><li><span>Identifies and reports member and provider educational opportunities to the Lead Intake Specialist.</span></li></ul><ul><li><span>Accurately answers questions regarding Plan benefits and Utilization Management requirements for members and providers.</span></li></ul><ul><li><span>Makes appropriate inquiries to determine potential coordination of benefits and advises appropriate provider and claims staff of same.</span></li></ul><ul><li><span>Supports Utilization Management nurses with data entry.<span>  </span></span></li></ul><ul><li><span>Performs other duties as assigned.</span></li></ul><ul><li><span>Adheres to Select Health and KMHP policies and procedures.</span></li></ul><ul><li><span>Supports and carries out the Select Health and Mercy Mission &amp; Values.</span></li></ul><p><b><span></span></b></p><p><b><span>Key Competencies/Success Factors:</span></b></p><ul><li><span>Excellent interpersonal and verbal communication skills.</span></li></ul><ul><li><span>Attention to detail and confidentiality.</span></li></ul><ul><li><span>Patience and a balanced demeanor.</span></li></ul><ul><li><span>Professional image.</span></li></ul><ul><li><span>Ability to write clear and concise reports.</span></li></ul><ul><li><span>Willingness to work any shift.</span></li></ul><ul><li><span>Availability for in-service training.</span></li></ul><p><span></span></p><p><b><span>Requirements/Certifications:</span></b></p><p><b><span>REQUIREMENTS:</span></b></p><ul><li><span>High School Diploma / GED<span>               </span><span>                </span> </span></li></ul><ul><li><span>Proficient PC Skills in a Windows based environment including word processing, spread sheets and working in database programs.<span>          </span><span>                </span> <span>               </span><span> </span></span></li></ul><ul><li><span>Proven ability to keep accurate and timely records and documentation according to established processes<span>        </span><span>                </span> </span></li></ul><ul><li><span>Experience as a medical assistant or role with similar responsibilities<span>         </span></span></li></ul><ul><li><span>Experience handling multiple calls or triaging calls</span><span><span>                </span></span></li></ul><ul><li><span>Medical Terminology, ICD, CPT, and coding experience<span>       </span></span></li></ul>",
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