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- Direct communications with customers, clients, providers via phone, email and any type of communication. For obtain medical or financial information to help in the estimated cost ( providers) before / during the patient is admititted
- Documentation of all calls or communications in the system
- Provide claims information like status, process date, detailed payment amount, check number, discounts taken, etc. to members, clients and providers by making the necessary contacts
- Identify potential problems and take prompt corrective actions in order to avoid escalated issues that require supervisory intervention.
- Coordination of medical appointments, this, in most cases, include locating and contacting several participating providers who have the availability and suit the patients preferences concerning location, language.
- Make decisions on when a specific issue needs to be brought to the attention of the supervisor/manager
- Follow up with insureds on claims in the appropriate timeframe in order to obtain updates, missing info, etc.
- Complete administrative tasks as delegated by your team leader and according to business needs including, but not limited Request financial updates after services are rendered, Verification of PPO participation and send VOB to providers,Data Entry: Policy creation and renewal, Claim/Event creation
- Serve as a resource for other departments and assist as needed
- Major Medical Insurance
- Life Insurance
- Internet and Electricity Support
- Aguinaldo 30 days
- Premium Vacation 100%
- Vacation days 10 days
Case Management Assistant - Mexico City, México - Global Excel Management Inc
Descripción
Job Description
The Case Management Assistant (CMA) is primarily responsible for the assisting in obtaining the required information to open, update, and, process a cases
The Case Management Assistant also will serve as an administrative resource to the Case Management department
Expected Outcomes and Actions Not limited to:
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