Job Type: Recruited Candidate Number of Positions: 1 System Location: CWR Created Date: 10/11/2023 Job Title: Clinical Assistant CWR Type: W-2 Reason: Resignation/Open Position

Qualifications: All applicants will be advised that BlueCross, as a federal contractor, may be required to implement a COVID-19 vaccine mandate.Job QualificationsEducationo High School Diploma or equivalentExperienceo 1 year - Customer service experience is requiredSkills\Certificationso Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)o Proficient oral and written communication skillso Proficient interpersonal and organizational skillso Exceptional time management skillso Ability to work independently under general supervision and collaboratively as part of a team in a fast paced environmento Independent, Sound decision-making and problem-solving skillso If current employee with the company, must meet minimum performance expectationso Extensive knowledge of all aspects of Utilization Management, Care Management, and Behavioral Health.o Knowledge and understanding of Medical terminologyo Solid knowledge and understanding of provider reimbursement methodologies, ICD-9-CM, CPT, HCPCS and UB-92 coding, UHDDS coding guidelines, AHA Coding Clinico Ability to talk and type simultaneously in a clear and concise manner while interacting with customers Responsibilities: Job Profile SummarySupports customer service activities and initiatives for a number of products or clients including but not limited to the Case Management and Utilization Management departments.Job DescriptionJob Responsibilitieso Screen incoming calls and/or faxes or other digital format for UM and/or CM and direct calls/faxes/other digital requests to the appropriate area. Identify and refer cases appropriately to the Case Management and/or Transition of Care department.o Receiving, investigating and resolving customer inquiries and claims. Maintain departmental goals. Perform projects, review and handle reports as assigned.o Load complete organization determination/notification for services designed by internal policy. Clearly document and key data in to the appropriate system using departmental guidelines.o Interact with membership, hospital and provider staff, advising of UM decision, status organization determinations, giving direction as necessary.o Search for and key appropriate diagnosis and /or procedure code as part of the notification /prior authorization process.o Must be able to pass required testing.o Participation and attendance are mandatory.o This position requires flexibility, due to rotations in schedules, and requires adherence to assigned schedules.o Work overtime as required Comments/Special Instructions
Attached Documentation: No record(s) found.

Requestor & Work Location

Requested by: N/A Alternate: N/A Report To: N/A Phone: N/A Ext.: N/A Travel Required: How Much Travel? Report To Manager's Office Address 1 Cameron Hill Circle, Chattanooga, TN 37402 United States Start Date: 11/6/2023 Work Days: Sun Mon Tue Wed Thu Fri Sat End Date: 2/5/2024 Start Time: 8:00 AM Total Reg Hours: 40.00 End Time: 5:00 PM Overtime Required: Lunch Time: 1 Hour Exempt: Open Bid:

Pay Type: Hourly Pay Rate (Min-Max): N/A Bill Rate (Min-Max): USD 21.00 - USD 28.00 Preferred Bill Rate: USD 0.00 Mark Up: 40.00%

Other Expenses: USD 0.00 Additional Spend: USD 0.00 Estimated Job Order Cost for 1 Contingent Worker(s): USD 14,784.00 Total Estimated Cost: USD 14,784.00

Initial Balance: USD 0.00 Spent Amount: USD 0.00 Remaining Balance: USD 0.00

Bill Rate (Min-Max) USD 21.00 - USD 28.00 Average Rate USD 21.00 - USD 28.00

Special Billing:

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