Remote Administrative Support - Medical Benefits

Jobvite, Inc.; Northern (KY); Hybrid; USD 45,847,000 - 57,308,000; Full time

Job summary

American Specialty Health Incorporated (ASH) is seeking an Administrative Support Representative to join our Medical Necessity/Benefits Administration department. This remote role supports data entry, form processing, and provider communications.

Requirements include a high school diploma and 2 years of data entry experience. You will manage MNR forms, contact practitioners and members, and document activities in the required logs while complying with state regulations.

Qualifications

• High School Diploma or GED Certificate required.
• 2 years of data entry experience and working knowledge of computers including word processing and spreadsheets required.
• Internal data entry experience at ASH preferred.
• Microsoft Word and Excel experience required. Experience with Microsoft Access highly desirable.

Responsibilities

• Research turnaround time using the Medical Necessity In Process Report.
• Check if the MNR Form is in house and advise staff to process it as priority.
• Reprint MNR Forms that cannot be located.
• Call practitioners to request re-faxing of MNR Forms as necessary.
• Document all calls in ASH proprietary system per MNA guidelines.
• Forward faxed MNR Forms to CQE for review.
• Call Providers and Members as required by the State and notify verbally per regulations.
• Document all calls in the required state log screen and process a minimum of 100 state calls per day.
• Prepare Medical Necessity Review Forms and bundle reports by teams.
• Deliver MNR Forms and reports to CQE within standards.
• Print and deliver file history as needed.
• Fax MNR Response Forms (MNRF) to practitioners using Broadfax and remove data entry errors.
• Prepare fax files and manage failed MNRFs for follow-up mailing.
• Contact practitioners on medical necessity determinations as required by State Law.
• Run MNRF queries in FoxPro; fax and mail MNRFs as needed.
• Perform other duties as assigned and comply with policies.

Skills

Data entry

Customer service

Education

High School Diploma or GED

Tools

Microsoft Word

Microsoft Excel

Microsoft Access

Job description

American Specialty Health Incorporated (ASH) is seeking an Administrative Support Representative to join our Medical Necessity/Benefits Administration department. This remote role supports data entry, form processing, and provider communications.

Requirements include a high school diploma and 2 years of data entry experience. You will manage MNR forms, contact practitioners and members, and document activities in the required logs while complying with state regulations.