Healthcare Call Center

This is a fully remote position, open to applicants in Texas.

📋 Description

• Manage cases through CMS and client portals by inputting, reviewing, and verifying eligibility and case details.

• Obtain medical records from external client systems and upload documentation into internal databases.

• Examine records and supporting materials for completeness, accuracy, and adherence to compliance standards.

• Prepare, input, monitor, and maintain case information across various systems and databases.

• Answer client inquiries related to case status, reports, documentation requirements, and general requests.

• Coordinate with internal teams about pending reports, case advancements, and workflow updates.

• Collaborate with physicians, providers, and clinicians to allocate cases and secure necessary documentation.

• Track case timelines and ensure accurate documentation and updates are maintained.

• Assist the Independent Dispute Resolution (IDR) process by reviewing documentation prior to clinical assessment.

• Uphold confidentiality and adhere to HIPAA, CMS regulations, and company policies.

• Conduct data entry, filing, documentation management, and provide administrative support functions.

⛳️ Requirements

• High school diploma or equivalent qualification.

• Proven experience in data entry and administrative roles.

• Exceptional attention to detail and skills in document review.

• Strong written and verbal communication skills.

• Ability to efficiently navigate multiple systems and databases at the same time.

• Comfortable handling medical records, insurance documentation, and confidential information.

• Proficient computer skills and adeptness with Microsoft Office applications.

• Reliable internet connection and a private workspace conducive to remote work.

• Proven ability to meet deadlines while maintaining accuracy in a high-volume setting.

• Previous experience in healthcare, insurance, utilization review, medical records, claims processing, or case coordination is preferred.

• Experience in reviewing contracts, legal documents, or detailed reports is preferred.

• Familiarity with CMS portals, eligibility verification, or healthcare administrative processes is preferred.

• Experience with regulatory and compliance-driven documentation is preferred.

• Knowledge of HIPAA and healthcare privacy regulations is preferred.

🏝️ Benefits

• Medical, dental & vision coverage.

• Critical Illness, Accident, and Hospital insurance.

• 401(k) Retirement Plan with options for pre-tax and Roth post-tax contributions.

• Life Insurance options (Voluntary Life & AD&D for employees and their dependents).

• Short-term and long-term disability coverage.

• Health Spending Account (HSA).

• Transportation benefits.

• Employee Assistance Program.

• Paid Time Off/Leave (PTO, Vacation, or Sick Leave).