ਕੰਮ ਦਾ ਵੇਰਵਾ

Position Overview

American Specialty Health Incorporated (ASH) invites applications for the role of Administrative Support Representative within its Medical Necessity/Benefits Administration (MNA) department. This full-time role serves as an essential communication bridge between the MNA and Clinical Quality Evaluation teams.

Work Environment and Requirements

This role is entirely remote, necessitating that the selected candidate work from a dedicated space in their home equipped with company-provided technology. Reliable internet connectivity is crucial, requiring a minimum speed of 50 Mbps download and 10 Mbps upload, with 100 Mbps down and 20 Mbps up recommended for optimal video conference quality.

Key Responsibilities

Utilize the Medical Necessity In Process Report to investigate processing times.
Coordinate with MNA personnel to verify receipt of Medical Necessity Review (MNR) Forms and prioritize their handling.
Reprint and request re-faxing of missing MNR Forms from practitioners as needed.
Accurately document all telephone communications within ASH's proprietary system following departmental protocols.
Forward faxed MNR Forms to Clinical Quality Evaluation for further assessment.
Conduct calls to healthcare providers and members as mandated by state law, ensuring verbal notifications are delivered in compliance with regulations.
Maintain detailed call logs in accordance with state requirements, handling a minimum of 100 such calls daily.
Prepare, bundle, and deliver MNR Forms and related documentation per team and daily reporting standards.
Manage fax transmissions and mailing of MNR Response Forms, including troubleshooting errors and performing manual mailings when necessary.
Execute queries and reporting tasks using FoxPro and Broadfax systems.
Engage in practitioner communications concerning medical necessity outcomes as legally required.
Perform additional duties as assigned, adhering strictly to company standards and policies.

Candidate Qualifications

Possession of a High School Diploma or GED certificate is mandatory.
Minimum of two years experience in data entry with proficient computer skills, including word processing and spreadsheet usage.
Prior internal data entry experience at ASH is preferred but not essential.
Competency in Microsoft Word and Excel is required; familiarity with Microsoft Access is highly valued.

Core Competencies

Exemplary interpersonal skills to foster respectful, collaborative relationships.
Customer service excellence geared towards internal and external stakeholders.
Strong listening and communication abilities to assess essential competencies aligned with organizational success.
Effective organizational and time management skills to juggle multiple priorities.
High accuracy and productivity amid a dynamic environment with frequent interruptions.
Analytical aptitude to interpret information and develop practical solutions.
Commitment to maintaining confidentiality at all times.

Physical and Environmental Conditions

Primarily sedentary role requiring prolonged sitting.
Capability to see, hear, and communicate effectively both verbally and in writing.
Ability to use telephone, keyboard, and mouse efficiently.
Capacity to lift objects weighing up to 10 pounds.
Position is performed in a work-from-home setting.

Diversity and Inclusion

American Specialty Health is an Equal Opportunity/Affirmative Action employer committed to creating an inclusive environment free of discrimination based on sex, gender identity, race, religion, disability, age, sexual orientation, veteran status, or any other protected class. Reasonable accommodations for disabilities are available upon request.

Administrative Support Representative