MAJOR DUTIES & RESPONSIBILITIES
Handling Receipt of New Cases:
Intake new cases and review/verify information and requests. Draft cases by entering information into the Dane Street systems.
Work with the client on any missing information pertinent to processing the claim.
Sort, organize, and create a medical document listing, if required by the client, in line with specific special handling.
Respond to inbound calls, emails, and portal inquiries.
Maintain efficient and accurate records related to all client interactions.
Ensure compliance with Federal NSA regulations, processes, and policies.
Collaborate with the Leadership team and other departments to ensure timely resolutions
Ability to process and interpret reporting.
Adhere to or exceed metrics/goals.
Assign/schedule new cases to physicians for review with the appropriate physician, based on location, reviewer availability, specific guidelines, jurisdictional requirements and other client requirements.
Ensure that the assigned physician has no conflict of interest with the case assignment.
Monitor, process, and track cases to ensure we meet deadlines.
Update clients frequently on cases in progress.
May communicate when there are questions on referral information to ensure proper documentation and information is provided to the assigned reviewer.
Ensure proper documentation for specified cases is provided to the client.
Maintain consistent professionalism at all times
Other duties & special projects, as assigned and based on business needs.