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in Norfolk, VA

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Hours Part-time, Full-time
Location Norfolk, Virginia 23501
Norfolk, Virginia

About this job

Job Description:

  • Managing incoming calls or incoming post services claims work.
  • Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests.
  • Refers cases requiring clinical review to a Nurse reviewer
  • Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate.
  • Responds to telephone and written inquiries from clients, providers and in-house departments.
  • Conducts clinical screening process.
  • Authorizes initial set of sessions to provider.
  • Checks benefits for facility based treatment.
  • Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner

Qualifications:

  • Requires High school diploma/GED; proficient analytically, written and oral communication skills; or any combination of education and experience, which would provide an equivalent background.
  • Medical terminology training and experience in medical or insurance field preferred.
  • Requires effective written, oral, and interpersonal communication skills. Microsoft Office; Word,Excel, Outlook and the ability to type 30-40 WPM.
  • Prior HEDIS experience a plus. Besides what is described in the job description, we are seeking an individual who is flexible, hard worker aligns with the goals and the ethic of the company and is a team player.




About Aerotek:

We know that a company's success starts with its employees. We also know that an individual's success starts with the right career opportunity. As a Best of Staffing® Client and Talent leader, Aerotek's people-focused approach yields competitive advantage for our clients and rewarding careers for our contract employees. Since 1983, Aerotek has grown to become a leader in recruiting and staffing services. With more than 250 non-franchised offices, Aerotek's 8,000 internal employees serve more than 300,000 contract employees and 18,000 clients every year. Aerotek is an Allegis Group company, the global leader in talent solutions. Learn more at Aerotek.com.

Aerotek is acting as an Employment Agency in relation to this vacancy.