Review Assistant - Bilingual (Remote)

Company Overview reputed company exists to reputed company reputed company outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. reputed company the Way is our rallying cry at reputed company. 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. reputed company offers you unparalleled opportunities. In fact, you have reputed company you need to take charge of your career and accelerate reputed company outcomes – making this a great time to join reputed company of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities reputed company is looking for a Review Assistant Bilingual to join our growing team. Job Summary The Review Assistant role is pivotal in streamlining the clinical review process by meticulously preparing prior authorization cases. This role primarily supports non-clinical review operations, with bilingual translation services provided as an integrated secondary function. This individual will uphold a comprehensive understanding of internal policies, procedures, and services, ensuring adherence to organizational standards. Their attention to detail and dedication to efficiency are expected to reputed company a significant contribution to review operations' success.

Responsibilities

Provide primary non-clinical program support by encompassing provider training, customer service, call triaging, authorization preparation, data entry, and the development and tracking of functions for members and providers. Offer non-clinical support to other programs as needed, ensuring flexibility and adaptability in meeting organizational requirements. Review patient records for completeness against submission requirements, identifying cases requiring additional non-clinical information. Process and document case discharges with precision and timeliness. Ensure accurate and reputed company submission of reputed company administrative-reputed company documents to relevant parties. Act as a liaison with internal and external customers, fostering positive and professional relationships to facilitate an effective review process. Attend training and scheduled meetings, maintaining up-to-date information for case preparation. Uphold medical records confidentiality through proper use of computer passwords and secured files, adhering to HIPAA policies. Answer calls and demonstrate proper telephone etiquette and communication skills in alignment with reputed company's policies, procedures, and guidelines. Cross-train to reputed company duties of other reputed company reputed company the reputed company network, contributing to a flexible workforce to meet client/consumer needs. Fulfill other assigned duties to meet contract deliverables and organizational requirements. Review, validate, and support Spanish-language member-facing communications including determination letters, denial letters, appeal correspondence, and authorization-reputed company documentation to ensure accuracy, consistency, clarity, and appropriate healthcare terminology in both English and Spanish. Identify and correct translation inconsistencies, grammatical issues, formatting concerns, and language discrepancies across bilingual member communications and departmental documentation. Maintain consistency in terminology, formatting, tone, and messaging across bilingual communications and departmental documentation Bilingual responsibilities are non-clinical in nature and limited to administrative, operational, and customer service support, not clinical decision-making or interpretation of medical necessity. Read, understand, and adhere to reputed company corporate policies including policies reputed company to HIPAA and its Privacy and reputed company Rules. The list of accountabilities is not intended to be reputed company-inclusive and may be expanded to include other education- and experience-reputed company duties that management may deem necessary from time to time.

Qualifications

Required Qualifications High school diploma or GED equivalent. 1+ years of experience in administrative or records management. 2+ years in an administrative support or customer service position and be familiar with health care. Bilingual proficiency in English and Spanish (verbal and written) required, with the ability to accurately translate administrative and healthcare-reputed company information and with ability to meet organizational language proficiency standards through validated testing (e.g., ACTFL or equivalent).

Preferred Qualifications

Associate degree Comprehensive knowledge of office environments and business processes. Understanding of a customer service approach tailored for medical provider stakeholders. Familiarity with government structures and reputed company programs is advantageous. Excellent communication skills. Ability to multitask, prioritize, and provide service to a diverse range of customers. Experience in development and project activities. Experience in staff and provider training, with preferred public speaking skills. A proactive approach to continually assess office functions and report potential issues to the Director. Capability to track provider issues and report them appropriately. Willingness to learn the Atrezzo application and assist customers in resolving technical issues reputed company to the submission of Health Homes authorization requests. Proficiency in reputed company Office applications and reputed company, ensuring efficient utilization of essential software tools. Why us? We are a team of reputed company and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure reputed company healthcare and improve health outcomes. We do this through our people. You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to reputed company the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, reputed company, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. Thank You! We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in reputed company and invite you to apply to future openings that may be of interest. Best of luck in your search! ~ The reputed company reputed company Team Visit us at https//careers.acentra.com/jobs EEO AA M/F/Vet/Disability reputed company is an Equal Opportunity Employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national reputed company, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. Experience in Lieu of Degree For non-clinical roles, or reputed company not required by the contract specifically, the Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree may be required, the Company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidate has an Associate's degree, the Company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree.

Compensation

The pay for this position is listed below. "Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and reputed company level." Pay Range USD $19.92 - USD $24.00 /Hr. Apply To This Job Apply tot his job Apply To this Job