Demonstrate a good working knowledge of medical terminology, human anatomy, and coding. Must possess knowledge of third party reimbursement regulations and billing practices. Possess moderate knowledge of level 1 and 2 modifiers.
Communicate with members about their medical needs. Skills and Requirements Include: Care coordination is provided primarily in person. GED or High School Diploma required. Minimum of one (1) year experience working with individuals with disabilities and/or mental health conditions.
Completing initial medical records reviews of patient records within 24-48 hours of admission. Required Skills: Travel may be required to meet the needs of the facilities. Active state Registered Nurse license. Graduate from a Nursing program, BSN, or graduate.
Has a current, unrestricted license issued by a state or territory of the United States. Strong computer and keyboarding skills. Required to hold a Florida clinical license or attain such within 6 months. Ability to comprehend medical policy and criteria to clearly articulate health information.
Minimum 2 years recent experience in medical-oriented scheduling environment. Bilingual in any of the following languages: Spanish. Adept at handling large call volumes, preferably with use of VOIP call systems. Experience with basic insurance guidelines.