United States onlyFollowing a 2022 merger of CNSI and Kepro, Acentra Health combines clinical services, technology solutions, and data analytics to accelerate better health outcomes. This is a great time to join our team of passionate individuals working together to pursue the most effective solutions to today’s complex healthcare challenges. Our culture is fueled by passion and driven by purpose.
Position Overview
As a Review Assistant, you will be an essential part of our team, significantly contributing to the efficiency of our review process. Your role involves meticulously preparing prior authorization cases for clinical review, streamlining operations to enhance our service delivery.
With an understanding of our internal policies, procedures, and services, both at the departmental and operational levels, you will ensure that our productivity and quality standards align with the contracted deliverables. Your responsibilities extend to the preparation of all related documentation, handling mailings, and compiling reports to fulfill eligibility, services, and hearing requirements. Join our team and play a key role in facilitating our mission to provide timely and accurate review services.
Job Responsibilities:
- Case Review Preparation: Reviews of patient records to ensure compliance with submission requirements. Determine the presence of all necessary information for each case and identify instances where additional non-clinical details are required.
- Case Management: Efficiently process and document case discharges, ensuring a seamless transition for all involved parties.
- Administrative Excellence: Ensure the accurate and timely submission of all administrative documents to the relevant parties, maintaining the highest standards of administrative support.
- Relationship Building: Foster positive and professional relationships, serving as a liaison between internal and external stakeholders. Your role is vital in ensuring effective collaboration and team building, essential for facilitating the review process.
- Professional Development: Take an active role in attending training sessions and meetings. You will be responsible for maintaining and utilizing current and updated information for case preparation, ensuring the highest level of proficiency and knowledge.
- Versatility and Flexibility: Engage in cross-training to perform duties across different contracts within the Acentra network. Your adaptability will contribute to a flexible workforce, ready to meet varying client and consumer needs.
- Additional Responsibilities: Be prepared to undertake other tasks as assigned. This list of responsibilities is dynamic and may be broadened to encompass other duties related to education and experience that management considers essential.
Required Qualifications, Knowledge, Skills, and Experience:
- A minimum of 1 to 2 years of experience in administrative roles or records management, preferably within a healthcare setting.
- An Associate’s Degree or equivalent work experience in medical, behavioral, or social/support settings is required. A Bachelor’s Degree is preferred, however not required.
- Understanding of record reviews, claims, or request processing in a healthcare context. Familiarity with the organization of medical records, medical terminology, and the disease process is essential.
- Experience with medical terminology and/or claims is advantageous. Demonstrated working knowledge of software applications relevant to healthcare or insurance fields.
- Demonstrated ability to function effectively within a team environment.
- Capable of interpreting complex documentation and organizing and presenting case information with clarity and accuracy.
- Ability to thrive in a fast-paced work environment, with excellent verbal and written communication skills.
- Proficiency in Microsoft Word and Outlook is required, along with the ability to learn and use proprietary software effectively.
- Strong critical thinking abilities are necessary for success in this role.
- Flexibility and strong organizational skills are crucial.
- Prior experience in Quality Improvement (QI) or Utilization Review would be nice to have.
Singularly Focused. Mission Driven.
Accelerating Better Outcomes is our Mantra! We are mission-driven to innovate health solutions that deliver maximum value and impact.
Why us?
We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.
We do this through our people.
You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.
Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.
Compensation
The compensation for this role is $19.00 to $22.00 per hour. Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.
EOE AA M/F/Vet/Disability
Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.
We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search.
