At arenaflex, we are committed to delivering exceptional healthcare services to our clients, and we are seeking a highly skilled and detail-oriented Administrative Data Entry Professional to join our Utilization Review and Peer Review Department for Workers' Compensation, Group Health & Disability. As a key member of our team, you will play a vital role in ensuring the accuracy and efficiency of our data entry processes, while providing exceptional support to our clinical staff, reviewing physicians, claims adjusters, and other stakeholders.
**About arenaflex**
arenaflex is a leading provider of healthcare services, dedicated to delivering high-quality care to our clients. Our team of experts is passionate about making a positive impact on people's lives, and we are committed to creating a work environment that is collaborative, inclusive, and supportive. We believe in the importance of ongoing learning and development, and we offer a range of opportunities for our employees to grow and advance their careers.
**Job Summary**
As an Administrative Data Entry Professional, you will be responsible for uploading referral forms, entering new referral data, verifying client requirements, and coordinating with nurses, physicians, and clients. You will also be responsible for assigning new referrals, completing referral procedures, and monitoring cases for utilization review. In addition, you will respond to communications from providers, claims adjusters, patients, and others, and place outbound telephone calls to schedule and facilitate review discussions. You will also be responsible for entering demographics and other information into claims or clinical management systems, maintaining data integrity, and distributing incoming and outgoing correspondence, faxes, and mail.
**Essential Functions and Responsibilities**
* Uploading referral forms
* Entering new referral data
* Verifying client requirements
* Coordinating with nurses, physicians, and clients
* Assigning new referrals and completing referral procedures
* Assigning, triaging, and monitoring cases for utilization review (UR)
* Responding to communications from providers, claims adjusters, patients, and others
* Placing outbound telephone calls to providers to schedule and facilitate review discussions
* Entering demographics and other information into claims or clinical management system and maintaining data integrity
* Obtaining all necessary information required for utilization review processing and case management from internal and external sources per policies and procedures
* Distributing incoming and outgoing correspondence, faxes, and mail; uploading review documents into paperless system as necessary
* General data entry, general data retrieval, general document and information retrieval, general business communication
* Participating in audits, accreditation, and other quality assurance functions
* Performing all job functions according to the related policies, procedures, instructions, laws, and regulations promulgated by the appropriate authority or the company
* Running reports
* Attending or assisting in training
* Supporting other units as needed
* Performing other duties as assigned
* Supporting the organization's quality program(s)
**Qualifications**
* High school diploma or equivalent
* Position Requirements:
+ High school diploma required, AA or BA degree preferred
+ Possesses excellent customer service skills
+ Ability to plan daily schedule and demonstrate good organizational skills
+ Professional and effective communication skills, both verbal and written
+ Competency in Microsoft Office, Excel, online database systems, and keyboarding
+ Ability to work independently, analyze information and problem solve
+ Good teamwork, organizational, decision making, and management skills
+ Capable of multitasking and meeting timeframes
+ Must be able to handle sensitive and confidential information with the highest degree of professionalism
**Preferred Skills and Qualifications**
* Previous professional experience in the medical field, healthcare, insurance claims, Workers' Compensation, managed care, medical management, and/or utilization review
* Medical terminology
* Bill review experience
**Work Environment and Culture**
* arenaflex is a remote work environment, and you will be required to work from home.
* You will be working in a fast-paced environment, and you must be able to multitask and prioritize tasks effectively.
* You will be working with a team of professionals who are passionate about delivering exceptional healthcare services.
* We offer a collaborative and inclusive work environment, and we encourage our employees to share their ideas and suggestions.
**Compensation and Benefits**
* arenaflex offers a competitive salary and benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off.
* We also offer opportunities for professional development and growth, and we encourage our employees to pursue their career goals.
**How to Apply**
If you are a motivated and detail-oriented individual with a passion for delivering exceptional healthcare services, we encourage you to apply for this exciting opportunity. Please submit your resume and cover letter to [insert contact information]. We look forward to hearing from you!
**Application Question(s)**
* Can you work 9 am PST to 6 pm PST?
**Shift Availability**
* Day Shift (Preferred)
**Work Location**
* Remote
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