Jobs in Health-Care

Provider Claims Service Centre 12
Integrated Resources, Inc    02-18-2020 Houston, TX, USA


Job Title: Provider Claims Service Centre

Job Location: Houston, TX

Job Duration: 7 Months (Extension possibility)

Job timings: Mon to Fri 8.00AM to 5.00PM

                          Training Shift 7.30AM to 4.00PM

 

Position Summary:

Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors. Triages resulting rework to appropriate staff. Documents and tracks contacts with members, providers and plan sponsors.

Duties:

  • Explains member's rights and responsibilities in accordance with contract.
  • Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system.
  • Educates providers on our self-service options; Assists providers with credentialing and re-credentialing issues.
  • Responds to requests received from Healthcare's Law Document Centre regarding litigation, lawsuits.
  • Handles extensive file review requests. Assists in preparation of complaint trend reports. Assists in compiling claim data for customer audits.
  • Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals.
  • Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management.
  • Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. Performs financial data maintenance as necessary.
  • Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received.

 

Experience:

  • 2+ years' recent experience in a call centre production environment OR customer service experiences in a transaction-based environment with extensive inbound/outbound phone experience REQUIRED.
  • 1-year minimum experience with Medicaid/Medicare or Health Insurance also in high volume production environment
  • Provider Claims or Medical Billing experience
  • 2+ recent years in a High-Volume Call Centre experience.


Education:

  • High School Diploma or GED required. Associates degree in Business, Accounting or equivalent work experience preferred.

 

Pharmacy Technician 6
Integrated Resources, Inc    02-17-2020 Totowa, NJ, USA

Job Role: Pharmacy Technician I

Job Location: Totowa, NJ

Job Duration: 4 Month+

Job Summary:

  • This position takes in-coming calls from members, providers, etc providing professional phone assistance to all callers through the criteria based prior authorization process
  • Maintains complete, timely and accurate documentation of all approvals and denials, and transfers all clinical questions and judgment calls to the pharmacist

 

Job Duties:

  • At least 1-year experience as a pharmacy technician coordinating activities in an administrative support function
  • National pharmacy technician certification
  • Eligible for state registration, certification or licensure per state regulations
  • Advanced computer skills including word processing and spreadsheet utilization
  • Excellent customer service skills (written and verbal) a must

 

Required Education:

  • Verifiable High School diploma or GED is required

 

Patient Access representative 13
Integrated Resources, Inc    02-17-2020 Bloomington, MN, USA

Title: Patient Access representative/Insurance verification specialist

Duration: 9 Months (Possibility of extension)

Location: Bloomington, MN

 

Responsibilities:

 

  • Provides support to assigned patient accounts by responding to inquiries or resolving issues of concern.
  • Applies standard techniques and procedures to routine instructions that require professional knowledge in specialist areas.
  • Provides standard professional advice and creates initial reports/analyses for review.
  • Provides and presents analysis summaries to immediate workgroup and clients as needed.
  • Acts as a backup contact to assigned accounts as needed

 

Qualification:

 

  • Strong PC skills.
  • Knowledge of Microsoft Office Suite.
  • Proficiency in Microsoft Excel.

 

 

Pharmacy Technician 7
Integrated Resources, Inc    02-17-2020 Chantilly, VA, USA

Job Title: Pharmacy Tech

Location: Chantilly, Virginia

Duration: 2 Months

 

Position Summary:

This position takes in-coming calls from members, providers, etc providing professional

phone assistance to all callers through the criteria based prior authorization process.

Maintains complete, timely and accurate documentation of all approvals and denials,

and transfers all clinical questions and judgment calls to the pharmacist.

 

Duties:

At least 1 year experience as a pharmacy technician coordinating activities in an administrative support function. 

National pharmacy technician certification. Eligible for state registration, certification or licensure per state regulations.

Advanced computer skills including word processing and spreadsheet utilization.

Excellent customer service skills (written and verbal) a must.Experience:Minimum (1) year experience required in a

customer service position with high volume call center experience; preferably in healthcare, social services, or a similar service position.

 

Education:

Verifiable High School diploma or GED is required.

 

Phlebotomist 6
Integrated Resources, Inc    02-14-2020 Ocoee, FL, USA

Job Title: Phlebotomist I    

Duration:  3 months

Location: Ocoee FL - 34761

Shift Time: 6:00a -12:00p M-F, Saturday rotation every other week.

 

Job Description:

  • The Patient Services Representative I (PSR I) represents the face of the company to patients who come in, both as part of their health routine or for insights into life-defining health decisions.
  • The PSR I draws quality blood samples from patients and prepares those specimens for lab testing while following established practices and procedures.
  • The PSR I has direct contact with patients and creates an atmosphere of trust and confidence while explaining procedures to patients and drawing blood specimens in a skillful, safe and accurate manner.
  • The PSR I will demonstrate Leadership Behaviors while focusing on process excellence skills and sensitivity to confidentiality and accuracy to patient information.
  • Under the direction of the area supervisor, perform daily activities of the Patient Service Center accurately and on time. Maintain a safe and professional environment.
  • Performs with confidence, both the forensic and clinical specimen collection and processing duties following established practices and procedures.
  • Maintains required records and documentation.
  • Demonstrates organizational commitment and promotes a positive image to patients, clients, employees and the public in general.

 

Job Requirements:

  • Ability to provide quality, error free work in a fast-paced environment. Ability to work independently with minimal on-site supervision.
  • Excellent phlebotomy skills to include pediatric and geriatric.
  • Flexible and available based on staffing needs, which includes weekends, holidays, on-call and overtime.

 

Required Education:

  • High school diploma or equivalent.
  • Medical training: medical assistant or paramedic training preferred.
  • Customer service in a retail or service environment preferred. Keyboard/data entry experience a must.

 

Would prefer 2 years or more Phleb. Experience. Temp replacement

 

Pharmacy Technician 14
Integrated Resources, Inc    02-14-2020 Lincoln, RI, USA

Job Title: Pharmacy Technician

Location: Lincoln, Rhode Island

Duration: 03+ Months

 

Position Summary:

  • Licensed Pharmacy Tech required to support the pharmacist in tracking lab data and prescriptions for infusion patients.
  • This position is located in a call center environment, not within a pharmacy.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Where allowed by local laws/regulations and branch procedures, processes patient prescription refills under the direct approval and supervision of the pharmacist.
  • Manages team schedule for patient deliveries.
  • Creates and maintains supply templates in the pharmacy computer database.
  • Assists with pharmacist in the communication with patient to manage supply inventory, meet patient delivery needs, access current condition (in non-clinical manner), validate insurance coverage, and medication supply needs.
  • Generates the delivery manifest for patient deliveries.
  • Documents all supply management activities in the patient medical record.
  • Assists in validating and/or obtaining authorizations for pharmacy services as requested.
  • Coordinates the management needs of catheter care patients under direct supervision of the pharmacist.
  • Participates in the asset tracking and management process as requested.
  • Assembles and maintain patient clinical charts and files documents. Gathers information for the initial admission packets (Patient Resource Guide) for new patients and reviews all new charts to ensure that all necessary nursing paperwork is included.
  • High school diploma or equivalent; some college preferred.
  • Minimum one year of experience as a pharmacy technician or clinically based customer service representative.
  • Must have National pharmacy technician certification required.
  • Demonstrated verbal and written communication skills.

 

Education:

  • Verifiable High School diploma or GED is required.

 

 

Health Care Specialist/Respiratory Therapist 14
SSI    02-13-2020 Lenexa, KS, USA

Description:

 

  • Attends work on a regular and predictable basis
  • Performs equipment set ups, specifically concentrators, durable medical equipment, etc. in a professional, safe and timely manner. This equipment is placed in apartments, private homes, clinics, hospitals, nursing homes and other areas where people with respiratory problems are treated
  • Ability to work independently and must be detail oriented, and have excellent organizational skills
Medical Technician 9
Integrated Resources, Inc    02-12-2020 Chaska, MN 55318, USA

Job Title: Medical Technician

Location: Chaska, MN

Duration: 12 Months (possibility of extension) on W2

 

Job Responsibilities:

  • Operation of hematology equipment and associated medical devices
  • Blood Born Pathogen training and knowledge of blood handling procedures.
  • Read, understand and follow company and department standard operating procedures.
  • Adhere to policies and procedures to reflect operations; ensure FDA, ISO and related regulatory requirements are consistently met.

 

Experience/Requirements:

  • Hospital laboratory experience (more than 1 year)
  • Minimum 2 year degree or equivalent.
  • Understanding blood handling procedures and work experience in a hospital or laboratory environment
  • Computer experience with some proficiency with MS Office (Word, Excel) • Strong attention to detail; a team player & perform well under deadlines
  • Ability to work various shifts (not night)
  • Prioritizes own work to complete assignments on a timely basis
  • Acts independently as appropriate
  • Able to work in a team environment

 

Medical Assistant 31
Integrated Resources, Inc    02-03-2020 Overland Park, KS, USA

Job Title:   Medical Assistant
Duration:  3 months (High possibility of Extension)  
Location:   Overland Park - KS

Required Qualifications:

  • Should have High school diploma or GED
  • Medical Assistants shall meet one of the following qualifications:
    Active Medical Assistant Certificate as a Certified Medical Assistant/CMA or as a Registered Medical Assistant/RMA  
  • At least 1 year of professional experience as a Medical Assistant in 'back-office' direct patient care with the ability to complete a client approved certification within one year from hire date.
  • Experience with MS Outlook and basic Computer knowledge
  • CPR certification
  • Must be a team player with excellent communication skills
  • Willingness to learn and be cross trained in other roles based on business need
  • This role is within a clinical office setting,
  • This role is considered patient facing and is part of client's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

 

Preferred Qualifications:

  • Experience with HEDIS
  • Experience with Electronic Medical Records
  • Active medical Assistant Certification or Registration from the following: American Association of Medical Assistant (AAMA), National Health career Association, American
  • Registry of Medical Assistants, National Association for Health Professionals, and/or American Medical Technologist
  • Minimum of 1-year professional experience as a Medical Assistant in 'back-office' direct patient care
  • Previous experience in a geriatric setting
  • Hands-on professional Phlebotomy experience
  • Bilingual English/Spanish fluent to speak, read, and write in both languages without limitations and assistance.

 

Pharmacy Technician 42
Integrated Resources, Inc    02-03-2020 Phoenix, AZ, USA

Job title: Pharmacy Technician

Job Location: Phoenix, AZ

Job duration: 6 Months (Temp to hire)

Job timings: Mon to Fri 8.00AM to 5.00PM

 

Position Summary:

  • Supports comprehensive coordination of Medicaid and/or Medicare pharmacy services including intake and processing of pharmacy authorization requests.
  • Promotes and supports quality effectiveness of healthcare and Pharmacy Services.
  • Evaluates, authorizes approval, and communicates decisions for pharmacy requests according to clinical guidelines.
  • High volume call centre and production unit.
  • Evaluates and authorizes approval of pharmacy requests received by telephone, facsimile, and/or other means using client clinical criteria. Determines appropriateness for medications. Communicates decision to physicians, physician's office staff, medical management staff, members, and/or pharmacists.
  • May perform clinical research to support request.
  • Utilizes various proprietary systems to build, research, process and enter requests.
  • Performs non-medical research including eligibility verification, COB, and benefits verification.
  • Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
  • Escalates requests to Pharmacist when request requires extensive clinical review or denial.
  • Promotes communication, both internally and externally, to enhance effectiveness of medication therapy management services.
  • Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
  • May communicate with Healthcare Case Managers and Health Plan staff.
  • Process requests in compliance with various laws and CMS regulations and company policies and procedures.
  • Sedentary work involving significant periods of sitting, talking, hearing, and keying.
  • Work requires visual acuity to perform close inspection of written and computer-generated documents as well as dual PC monitors.

 

Qualification:

  • Pharmacy Technician certification is A MUST

 

 

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