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Peer Review Coordinator

Company: Genex Services, LLC.
Location: Boca Raton
Posted on: January 7, 2022

Job Description:

Company Overview The Enlyte Family of Businesses Mitchell - Genex - Coventry Enlyte is the parent brand of Mitchell, Genex and Coventry, an organization unlike any other in the Property & Casualty industry, bringing together three great businesses with a shared vision of using technology innovation, clinical services and network solutions to help our customers and the people they serve. Our suite of products and services enable our employees to help people recover from challenging life events, while providing opportunities for meaningful impact and career growth. Job Description

  • Delivers quality Customer Service from initial request for service until completion of end product
  • Adheres to client protocols and jurisdictional regulations including, logging, processing and progress inquiries
  • Ensures all Peer referrals have been entered and cases created accurately
  • Facilitates Peer Services by receiving request and securing appropriate provider and handling all aspects of the Peer Service until end result has been reached
  • Communicates with customer regarding specialties, timeframes and fees
  • Secures needed medical records from clients and/or designated contact
  • Sorts and prepares medical records for imaging/scanning
  • Keeps Client apprised in regard to any scheduling delay or issue
  • Understanding and knowledge of basic credentialing needs and ability to review and discuss with provider office effectively
  • Contacts appropriate agencies or persons for the purpose of verifying information
  • Understanding of client specific forms, ability to enter and process appointment information in various customer systems as necessary
  • Handles incoming and outgoing calls effectively and efficiently meeting client standards/protocols
  • Communicates immediately with Supervisor with regard to any client concerns
  • Meets specific department metrics
  • Operates company software and equipment
  • Enters data by inputting alphabetic and numeric information into system via keyboard
  • Demonstrates strong organizational skills with the ability to multi-task without compromising extreme attention to detail
  • Communicates using correct English, spelling, grammar, and punctuation
  • Ability to understand and follow oral and written instructions while adhering to prescribed departmental routines
  • Proficiency with imaging/scanning documents
  • Maintains confidentiality and discretion as a general rule
  • Works effectively as a team contributor on all assignments
  • Interacts professionally with other employees as well as clients
  • Has a clear and concise understanding, and adheres to, guidelines as they relate to HIPAA, Conflict of Interest, and Ethics
  • Understands current URAC standards as appropriate to job functions Qualifications
    • HS Diploma or equivalent
    • Remote employees in this position will be expected to ensure the protection of proprietary Company and customer information accessible from their home or satellite office. - -Steps include, but are not limited to, use of locked file cabinets, disk boxes and desks, regular password maintenance, and any other steps appropriate for the job and the environment
    • Proficient with MS Office Suite
    • Excellent communication skills-verbal and written
    • Ability to organize and prioritize work effectively
    • Ability to accept and apply constructive feedback Benefits We're committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. - The Company is an equal opportunity employer, values the diversity of our workforce and the knowledge of our people. The Company does not discriminate against an applicant or employee on the basis of race, color, religion, national origin, ancestry, sex/gender, age, physical or mental disability, military or veteran status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state or local law. - #LI-ALLEXIS

Keywords: Genex Services, LLC., Boca Raton , Peer Review Coordinator, Other , Boca Raton, Florida

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