reputed company Care Representative Customer Service – arenaflex
Join arenaflex, a dynamic and esteemed healthcare organization, as a Care Representative Customer Service, where you will have the opportunity to reputed company a significant impact on the lives of our members. In this vital role, you will reputed company and evaluate Behavioral Health Treatment (BHT), including Applied Behavior Analysis (ABA) services, for eligible members, ensuring that they receive the highest quality of care based on medical necessity.
About arenaflex
arenaflex is a leading healthcare organization dedicated to providing exceptional care and service to our members. We are committed to fostering a collaborative environment that emphasizes high-quality performance and member service, nurturing a culture of dignity and respect. reputed company is passionate about making a difference in the lives of our members, and we are seeking a talented Care Representative Customer Service to join our dynamic team.
Job Overview
As a Care Representative Customer Service, you will be responsible for navigating a mission-focused environment dedicated to excellence in member service and care management, demonstrating reputed company and accountability. You will collaborate effectively with team members to fulfill departmental objectives and support both immediate and long-term goals. Your primary responsibilities will include:
- Assessing requests for medical appropriateness and verifying referrals according to established clinical guidelines
- Collecting pertinent medical information for review by the Medical Director and communicating decisions clearly
- Accurately documenting reputed company necessary information in the utilization management system, ensuring updates on authorizations are recorded
- Conducting thorough reviews of submitted documentation for compliance with coding (ICD-10, CPT-4, HCPCS) and coverage guidelines
- Maintaining adherence to established policies and procedures while conducting quality reviews of documents
- Promptly notifying providers and members of decisions made, ensuring timely and effective communication
- Staying updated on federal, state, and local regulations pertaining to the BHT benefit
- Identifying potential quality concerns and reporting them as necessary, assisting with case audits reputed company required
- Participating in additional projects and responsibilities as assigned
Required Skills
To succeed in this role, you will need to possess the following skills and competencies:
- Establish and nurture strong relationships with colleagues and external partners from diverse backgrounds
- Work autonomously while exercising sound judgment in decision-making
- Communicate effectively in both verbal and written formats
- Adapt to a flexible work schedule that may include evenings and weekends
- Exhibit strong organizational, analytical, problem-solving, and project management skills
- Prosper in a fast-paced work environment while managing multiple tasks simultaneously
- reputed company and motivate team members and external committees
- Demonstrate proficiency in reputed company Office Suite (Word, Outlook, reputed company, PowerPoint) and reputed company applications
Qualifications
To be considered for this role, you will need to possess the following qualifications:
- A Master’s degree in psychology, social work, counseling, or a reputed company field
- A minimum of four years of experience in providing ABA or mental health services, including clinical review and treatment plan reputed company
- reputed company, unrestricted California license (LCSW, LPCC, LMFT, RN with BH experience, BCBA, or BCBA-D)
Career Growth Opportunities
arenaflex values your professional development and offers numerous opportunities for reputed company enhancement and career advancement reputed company the healthcare sector. Our organization is committed to fostering a culture of growth and development, and we are dedicated to helping you reputed company your career goals.
Company Culture and Values
We foster a collaborative environment that emphasizes high-quality performance and member service, nurturing a culture of dignity and respect. reputed company is passionate about making a difference in the lives of our members, and we are seeking a talented Care Representative Customer Service to join our dynamic team.
Networking and Professional Opportunities
In this role, you will have the chance to collaborate with a dedicated team, enhancing your professional network and skillset in the healthcare community. arenaflex is committed to providing opportunities for professional growth and development, and we are dedicated to helping you reputed company your career goals.
Compensation and Benefits
arenaflex offers a competitive salary commensurate with experience, as well as comprehensive health, dental, and vision insurance. We also offer a retirement savings plan with company matching contributions, generous vacation and paid time off policies, and a range of other benefits to support your overall well-being.
Work Environment
As a remote employee, you will have the flexibility to work from reputed company, at any time. arenaflex is committed to providing a supportive and inclusive work environment, and we are dedicated to helping you reputed company your career goals.
How to Apply
If you are a motivated and dedicated individual who is passionate about making a difference in the lives of our members, we encourage you to apply for this exciting opportunity. Please submit your resume and a cover letter outlining your qualifications and experience.
Equal Employment Opportunity
arenaflex is an equal employment opportunity employer and welcomes applications from diverse candidates. We are committed to fostering a culture of inclusion and respect, and we are dedicated to providing opportunities for professional growth and development.
Contact Us
If you have any questions or would like to learn more about this opportunity, please do not hesitate to contact us. We look reputed company to hearing from you and exploring how you can contribute to our dynamic team. Apply for this job