Case Management Assistant

hace 6 meses


Mexico City Global Excel Management Inc A tiempo completo

Job Description

Position Purpose and Description


The Case Management Assistant (CMA) is primarily responsible for the assisting in
obtaining the required information to open, update, and, process a case.
The Case Management Assistant also will serve as an administrative resource to the
Case Management department


Expected Outcomes & Actions – Not limited to:
• Direct communications with customers, clients, providers via phone, email and any
type of communication. For obtain medical or financial information to help in the
estimated cost ( providers) before / during the patient is admititted
• Documentation of all calls or communications in the system
• Provide claims information like status, process date, detailed payment amount,
check number, discounts taken, etc. to members, clients and providers by making
the necessary contacts
• Identify potential problems and take prompt corrective actions in order to avoid
escalated issues that require supervisory intervention.
• Coordination of medical appointments, this, in most cases, include locating and
contacting several participating providers who have the availability and suit the
patients preferences concerning location, language.
• Make decisions on when a specific issue needs to be brought to the attention of the
supervisor/manager
• Follow up with insureds on claims in the appropriate timeframe in order to obtain
updates, missing info, etc.
• Complete administrative tasks as delegated by your team leader and according to
business needs including, but not limited Request financial updates after services
are rendered, Verification of PPO participation and send VOB to providers,Data Entry:
Policy creation and renewal, Claim/Event creation
• Serve as a resource for other departments and assist as needed

KSA (Knowledge, Skills and Abilities/Attitudes)
• Superior customer service skills;
• Excellent interpersonal skills;and Team Player
• High level of professionalism;
• Good problem-solving skills;
• Highly organized with ability to multi task and prioritize;
• Excellent communicate skills
• Good computer skills (Microsof Office suite)
• Attention to detail
• Flexibility
• Problem solving skills
• Positive attitude
• Result oriented
• Self-confidence
• Understanding the corporate client culture/expectations

Requirements and Qualifications
• High School diploma
• + 3 years of experience in Assitance Coordinator or insurance experience
• Bilingual (English/Spanish)
• Clear and effective communication in both English and Spanish (written and
verbal)
• Knowledge of commonly used claims and health insurance terminology
• Multitasking and prioritizing
• Follow up
• Detailed oriented and organizational skills
• Proficiency in the Microsoft suite products

We offer you

Global Excel offers more than a position; we offer a professional future with a competitive compensation including base salary, performance bonus and benefits.

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