Review Clerk - (Fully Remote) - Must be comfortable working EST shifts and hours

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Position Overview'

As a Review Clerk, you'll play a pivotal role in providing comprehensive administrative support to a team, department, or individual, reporting directly to the Manager of Medical Review Services. This position is instrumental in facilitating office operations, offering assistance in day-to-day functions, conducting non-clinical support activities such as data entry and report tracking, and ensuring seamless access to services for external customers.

You will be coordinating office tasks, organizing training materials, managing data entry into various software platforms, handling inquiries, and appropriately directing calls. You will be entrusted with the critical responsibility of managing and safeguarding confidential information. This role will also involve overseeing logistical arrangements for meetings and calls, ensuring smooth coordination among staff, and undertaking special projects as required to fulfill business objectives.

Job Responsibilities

• Provide administrative and clerical support to the case review staff.
• Open, process, and distribute all incoming faxes and mail daily, ensuring prompt and accurate updating of case information while capturing essential details.
• Monitor incoming paperwork, verifying accurate reception and recording of information in designated forms and databases.
• Review case review files daily, furnishing Case Review Specialists and Case Review Managers with timely updates on all case review activities.
• Initiate the case review process by aiding clients in transmitting case-specific information to case managers through service request form completion or online portal submissions.
• Collaborate with Case Review Managers to follow up with reviewers regarding specific cases through effective communication channels (telephone, email, or fax).
• Appropriately package, label, and dispatch or transmit correspondence, medical records, and supporting documentation via secure methods (fax, secure email, or web portal) for case reviews to patients and clients.
• Copy, scan, and securely manage patient medical records as required for individual case reviews, maintaining strict confidentiality in compliance with internal policies.
• Organize and file all case review documents systematically, ensuring controlled access to files.
• Facilitate communication between clients and reviewers as needed.
• Monitor and handle incoming telephone calls for the case review department, ensuring proper routing of client and reviewer calls.
• Assist in revising, adding, or updating policies, procedures, forms, or other documents pertinent to the case review and credentialing process.
• Contribute to the preparation and dissemination of proposal requests for the IMEDECS program.
• Provide support in answering and directing phone calls when necessary.
• Verify absence of conflict of interest for clients or reviewers on a case-by-case basis.
• Package and dispatch medical record information, documentation for case reviews to reviewers, and relevant summaries to clients in accordance with standard procedures.
• Forward completed files to the Accounting department for processing and conduct electronic archiving of files upon the completion of each case.

Required Qualifications and Experience

• High School Diploma or Equivalent: Minimum educational requirement.
• Preferential Knowledge of Medical Terminology: Experience within a healthcare setting is advantageous.
• Proficiency in Data Entry: Competent in efficiently inputting individual case review and reviewer information into the case review database when required.
• Preferred Secretarial Experience or Training: Previous experience or training in a secretarial capacity is beneficial.
• Computer Proficiency: Proficient in Microsoft Office suite, including word processing, and proficient in navigating the Internet.

Why us?