Medical Case Specialist I-AWW (Thurs-Sunday)
Company: QTC Management, Inc.
Location: Jourdanton
Posted on: January 27, 2023
Job Description:
Job Summary:
Under limited supervision, performs a variety of activities in
support of a specific project/business/technical unit. Gathers,
collects, records, tracks and verifies data and information from
multiple sources. Uses software for functional area to schedule
appointments and document in the case management systems. Compiles
and generate reports, statistics, timelines, tables, graphs,
correspondence and presentations. Provides data and information to
others on functional unit processes and procedures. Delivers
exceptional customer service at all customer touch points.
Essential Duties and Responsibilities: -
- Must have the ability to work from Thursday to Sunday.
- Answer phones from automated call distribution system
- Triage daily download of referrals and ensure appropriate
worksheets are assigned to corresponding conditions as identified
by Veteran's Administration
- Verify appropriate CPT and CLIN codes are assigned to each
case
- Communicate directly with claimants and providers
- Obtain medical history for specific conditions
- Determine appropriate examinations, tests and specialists
required for each case
- Schedule appointments for examinees including follow-up
appointments and rescheduled appointments
- Ensure all examinees and providers receive necessary
documentation
- Confirm consultative reports and diagnostic test results are
received in a timely manner
- Meet or exceed contract timeliness guidelines in both the
scheduling and case management systems
- Other projects and duties as assigned
-Competencies:
- Proven ability to plan and organize work load
- Ability to manage competing priorities in a fast paced work
environment
- Good follow through skills
- Must possess the ability and flexibility to work early morning,
evening, and/or weekend shifts
Education and/or Experience:
- High School diploma, or equivalent (GED) or 2 years of
additional relevant experience in lieu of diploma/GED
- Must be able to successfully pass National Agency Check with
Inquiries (NACI) background investigation
This job description supersedes all prior job descriptions and is
intended to describe the general content and essential requirements
for the position listed above. It is not to be construed as an
exhaustive statement of requirements, duties and responsibilities.
Management reserves the right to add or change the duties of this
position as required at any time.
-QTC Management Inc. is a VEVRAA Federal contractor and an Equal
Opportunity Employer. The company has an ongoing commitment to
affirmative action and the creation of a workplace free of
discrimination, harassment and retaliation. The company recruits,
hires, trains, and promotes individuals in all job titles without
regard to race, color, creed, religion, ancestry, national origin,
age, sex, sexual orientation, people with disabilities protected
under law, and protected veteran status.
#CNTExperienceRequired
- Less than 1 year(s): Experience in healthcare, medical, or
insurance related industriesPreferred
- Direct healthcare experience in medical case management or
quality assurance to include the review of complex multi-focal
medical reports for quality, clarity, thoroughness and insightful
medical explanation
- Experience with electronic medical scheduling and case
management software EducationRequired
- High School Diploma or better
- GED or betterLicenses & CertificationsPreferred
- Medical Assistant
- Certified Medical Coder
- Certified Nursing AsstSkillsRequired
- Written Communication
- Verbal Communication
- Computer LiteracyPreferred
- Problem Solving
- Medical Documentation
- Customer Service
- Multi-line phone
- MS Office
- Medical Scheduling Software
- Medical Terminology
- Medical Data Entry
- Electronic Medical RecordsBehaviorsPreferred
- Enthusiastic: Shows intense and eager enjoyment and
interest
- Detail Oriented: Capable of carrying out a given task with all
details necessary to get the task done well
- Team Player: Works well as a member of a group
- Innovative: Consistently introduces new ideas and demonstrates
original thinkingMotivationsPreferred
- Work-Life Balance: Inspired to perform well by having ample
time to pursue work and interests outside of work
- Goal Completion: Inspired to perform well by the completion of
tasks
- Job Security: Inspired to perform well by the knowledge that
your job is safe
- Growth Opportunities: Inspired to perform well by the chance to
take on more responsibilityEqual Opportunity Employer/Protected
Veterans/Individuals with DisabilitiesThe contractor will not
discharge or in any other manner discriminate against employees or
applicants because they have inquired about, discussed, or
disclosed their own pay or the pay of another employee or
applicant. However, employees who have access to the compensation
information of other employees or applicants as a part of their
essential job functions cannot disclose the pay of other employees
or applicants to individuals who do not otherwise have access to
compensation information, unless the disclosure is (a) in response
to a formal complaint or charge, (b) in furtherance of an
investigation, proceeding, hearing, or action, including an
investigation conducted by the employer, or (c) consistent with the
contractor's legal duty to furnish information. 41 CFR
60-1.35(c)
Keywords: QTC Management, Inc., San Antonio , Medical Case Specialist I-AWW (Thurs-Sunday), Healthcare , Jourdanton, Texas
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