Health Entry Coordinator; Remote

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Founded in 1983, we’re a clinically-driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to healthcare organizations.

• A competitive compensation package.
• Benefits include healthcare, vision and dental insurance, a generous 401k match, paid vacation, personal time, and holidays.
• Growth and training opportunities.
• A team atmosphere with fun events and prizes scheduled throughout the year.

Our Health Entry Coordinator is responsible for carrying out day-to-day departmental tasks and completing all processes for screening incoming review requests, preparing review information and materials for assignment to appropriate Reviewers and maintaining online case summary/tracking system information.

• To prepare high-quality, complete packets of appropriate case review information and materials for submission to the panel reviewers.
• To serve as company liaison with clients, reviewers, and practitioners/providers/facilities whose services are subject to review.

• Screen incoming review requests for completeness of materials required to conduct the review of the case.
• Prepare, organize, distribute, and present records, materials, and forms required for a complete case review packet for Reviewers.
• Identify appropriate Reviewers for case review assignment including: determine their availability for a review assignment; and obtain information for delivery of the case to the reviewer, if applicable.
• Contact clients to resolve questions, obtain information, records and/or materials needed for a case review and resolve issues about active cases.
• Respond to reviewers’ requests for additional information/materials necessary for a review and notify clients and other internal departments of these needs, as applicable.
• Coordinate and record phone consultations between Reviewers and practitioners/providers/facilities that are party to a review case.
• Create and maintain an in-house review file for each active case.
• Respond to inquiries from clients, other entities referring cases for review, and practitioners/providers/facilities.
• Support all Quality Management initiatives.
• Actively participate in the Complaint Process and Provider Relations assessment process.
• Support all Compliance Program activities.
• Provide backup support to staff in other areas as applicable.
• Participate in all company meetings and committees as requested.
• Maintain a flexible schedule to meet client needs.
• Adhere to all policies and procedures.
• Take feedback and responsibility for performance.
• Adapt to differences of clients.
• Complete other duties and responsibilities as directed.

• Ability to work under pressure and meet deadlines while managing multiple high priorities.
• Personal computer literacy and high competency in use of Microsoft Word, Microsoft Excel and Adobe.
• Strong working knowledge of basic anatomy, physiology and medical terminology.
• Strong detail orientation.
• Strong organizational skills.
• Strong oral and written communication skills.
• Well-developed customer service and training skills.
• Ability to work independently with minimal supervision.
• Understanding and knowledge of company's clients, products, departments and workflows, and applicable regulatory requirements and accreditation standards.

• Minimum of one year’s experience in similar operations.
• Experience in health care, managed care or utilization management company.

• High school diploma.
• Preference for Bachelor's degree preferably in business or health care.

Ability to sit at a desk, utilize a computer, telephone, and other basic office equipment is required. This role is designed to be a remote position (work-from-home).

Diversity creates a healthier atmosphere:
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status,…