Medical Case Manager - Medical Audit Professionals
Miami, FL 33138
About the Job
Immediate vacancy available. We are looking for a foreign medical graduate ( ONLY), Spanish, English speaker, and or other languages with an excellent work ethic in Miami Florida geographical area. no experience is required. we will train. computer multitask skills required to deal with emergencies.
Open position night shift/or day shift schedule available:
- A full-time job 8 hrs shift ---m-f : 05pm est- 100am est ( 40hrs/week or).
- A Day-time job 8 hrs shift ---m-f : 09am est- 0500pm est ( 40hrs/week).
- Both shifts require availability to be on-call - must be able to be on-call from 100 am est--900 am est 2 nights/week remotely.
- Must be able to be oncall remotely 2 weekends/ month from friday 100am est- monday 900am est monitoring /answering emergency emails, calls, case managing emergencies, etc..
- Any Worked hours during OnCall will be paid on an hourly after-hours rate basis as additional to the base payment.
At the Operation office in the Miami Shores area.
Once the candidate passes the proper paid training (2-3 WEEKS), the candidate will be working at the office and remotely. if dropped out of training without 30 days' notice. hours spent in training will be voided and paid.
The right candidate must be a foreign medical graduate initially, have the ability to start immediately working and handling medical benefits verification and medical pre-authorization service, inpatient care review, itemized bill review, must be able to cover phone calls during their shifts. In addition, the candidate must have excellent verbal communication skills, computer proficiency, and customer service experience.
Responsibilities:
- Answer inbound calls.
- eMail monitoring average 70 eMails per day.
- Handle providers inquiries for benefit verification.
- Manage and resolve customer complaints.
- Provide customers pre-authorization for medical services.
- Medical records review.
- itemized Bill Review.
- Escalate priority issues.
- Document all activities and call information according to standard operating procedures.
- Reviewing medical records and assess for pre-existing condition and relevant exclusions on the policy.
Core Competencies:
- Must be Foreign Medical Graduate.
- Must have not passed USMLE STEP1 STEP 2 Nor CSA.
- Verbal and written communication skills ( English & Spanish, other languages) are welcomed.
- MS Access/Word/Excel proficiency.
- Listening skills.
- Problem-solving.
- Customer service oriented.
- Organizational skills.
- Detail-oriented.
- Adaptability.
- Team player.
- Resilience.
Job Type:
- Full-time, Contract hourly-paid $16.00 -$24.00/Hr.
Language:
- Spanish and English (required) and Portuguese (preferred), any other languages are welcomed in addition to the required ones.
Source : Medical Audit Professionals
