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Managed Care Coordinator
Ref No.: 18-30462
Location: Mt. Laurel, New Jersey
Position Type:Contract
Start Date / End Date: 06/18/2018 to 12/18/2018
Job Summary:
Company : Artech Information System
Job Title: Managed Care Coordinator
Location: Mt. Laurel, NJ, 08054
Duration: 6 Months

Job Diva ID: 7185-1

Job Description:
This position supports the Health Services and Utilization Management functions and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators.

Responsibilities: -
Performs review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients. - Handles initial screening for pre-certification requests from physicians/members via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff. - Prepare, document and route cases in appropriate system for clinical review. - Initiates call backs and correspondence to members and providers to coordinate and clarify benefits. - Upon completion of inquiries initiate call back or correspondence to Physicians/Members to coordinate/clarify case completion. - Reviewing professional medical/claim policy related issues or claims in pending status. - Upon collection of clinical and non-clinical information MCC can authorize services based upon scripts or algorithms used for pre-review screening. *Non Clinical staff members are not responsible for conducting any UM review activities that require interpretation of clinical information. - Perform other relevant tasks as assigned by Management.

Core Individual Contributor Competencies:
Personal and professional attributes that are critical to successful performance for Individual Contributors: Customer Focus Accountable Learn Communicate

Education: -

High School Diploma required. Some College preferred.

Work experience: -
Prefer 1-2 years customer service or medical support related position.

Specialized knowledge/skills: -
Requires knowledge of medical terminology - Requires Good Oral and Written Communication skills - Requires ability to make sound decisions under the direction of Supervisor - Prefer knowledge of contracts, enrollment, billing & claims coding/processing - Prefer knowledge Managed Care principles - Prefer the ability to analyze and resolve problems with minimal supervision - Prefer the ability to use a personal computer and applicable software and systems - Team Player, Strong Analytical, Interpersonal Skills

Thanks & Regards

Prithwiraj Chakraborty
Associate Recruiter
360 Mt. Kemble Avenue, Suite 2000 | Morristown, NJ 07960
Office: 973.507.7548 | Fax: 973.998.2599
Email: | Website:
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