Provider Dispute Resolution Clerk

US-CA-Alameda
3 months ago
Job ID
2017-1679
# of Openings Remaining
1
Experience (Years)
2

Overview

Under general supervision of the Provider Dispute Resolution (PDR) Manager performs a variety of complex, responsible and confidential duties requiring a thorough knowledge of organizational procedures and precedents; perform routine clerical, administrative duties in support of the Provider Dispute Resolution Unit.  This position requires the ability to work independently, maintain confidentiality, exercising judgment and initiative.

Responsibilities

· Provide administrative support to the Provider Dispute Resolution Unit and the Provider Dispute Resolutions directors and managers as needed.

· Answer telephone calls and tactfully handle inquiries and/or transfer calls to the appropriate party.

· Monitor and respond to incoming calls, emails, faxes and mail as directed by the PDR staff and complete intake of new PDR cases.

· Independently respond to other departments, letters and general correspondence for inquiries of a routine nature.

· Assist the PDR staff in initiation or completion of cases or projects and work with the PDR Lead to support day to day operations.

· Prepare PDR cases by printing, labeling and organizing files for clinical review when needed.  May require frequent use of medical or technical terminology and which combines materials from several sources.

· Prepare meeting agendas, relevant supporting documentation, keep minutes of meetings, and send recap information to the department on a weekly basis.

· Manage work in a confidential manner; ensuring information is shared with internal and external individuals as appropriate.

· Maintain appointment schedules and calendars for the PDR Unit; gather information and contact meeting participants.

· Assist in compiling files/documents for regulatory audits and familiarize self with DMHC regulations as they apply to position.

· Operate general office equipment such as personal computer, copier, fax, and other office machines.

· Perform other duties and special projects as assigned.

Qualifications

EDUCATION OR TRAINING EQUIVALENT TO:

 

· High school diploma or equivalent experience.

 

MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:

 

· 2 years related administrative experience.

· 1-2 years of customer service experience (telephonic preferred).

 

SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):

 

· Knowledge of managed care and medical terminology;

· Excellent verbal and written communications skills;

· Team player who builds effective working relationships;

· Strong organizational skills;

· Proficient experience in Microsoft Word, Excel, Access, Outlook, and PowerPoint; and

· Excellent verbal and written communication skills a must.

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