Job Description
Responsible for monitoring, facilitating, and reviewing processes and information to determine if standard procedures set forth were accurately used.
Responsibilities
- Medical Information Review
- Data entry of medical and bill information.
- Checks data initially entered for accuracy and completeness.
- Processes client information.
- Analyzes medical information for appropriateness.
- Summarizes information to prepare reports as necessary.
- Conducts quality assurance on processes and documents.
- Contacts with stakeholders, either through phone call or email to coordinate medical treatment schedule.
- Approves payments of medical bills.
- Assists and collaborates with onshore partners in resolving and put claims to closure.
- Finance Information Review
- Act as the point of contact in the absence of a Team Lead or Supervisor
- Handle complex scenarios that would require further analysis and decision making (I.e., Client account reconciliation, billing history, etc.)
- Processes client information.
- Ensure the accuracy of financial data that is provided both internally and externally.
- Summarizes information to prepare reports as necessary and be able to explain these financial reports.
- Conducts quality assurance on processes and documents.
- Facilitates any additional training needed by the team.
- Business Process Support
- Analyzes and resolves any issues and inquiries regarding matters of work in a customer-oriented approach.
- Routes tasks to appropriate processor by utilizing internal systems.
- Refers matters beyond limits of authority and expertise to immediate superior for direction.
- Upholds the Crawford Code of Conduct by protecting the confidentiality of information.
- Adheres to the standard operating procedures (SOP) and turnaround time set by the company.
- Performs variety of administrative duties and other related tasks from time to time as assigned to contribute to other business processes.
Qualifications
- Bachelor's degree in any related field
- At least two (2) years related work experience.
- Must:
- Proficient typing skills.
- Good communication skills.
- Proficient in word processing and spreadsheet softwares.
- High analytical skills in reviewing medical information or financial information.
- Desired:
- Competence in case management outcomes.
- Knowledge and understanding of QI and QA practices.
- Ability to multi-task, prioritize and manage time effectively.
- Keen attention to details in order to produce quality output.
- Maintains high degree of professionalism and confidentiality.
- Interpersonal skills - Able to work independently and as a team member.
