Overview
Skills
Job Details
Job Description
This position acts as the primary point of contact for processing documents related to service reductions, reviewing, and coordinating all process activities with DES/DDD. This position will require critical thinking and the ability to determine if the documentation supports the requirements of the adverse benefit change.
Skills:
Ability to conduct research
Ability to understand, interpret, and apply Federal and State laws, statutes, rules, regulations, and policies Ability to convey complex information in a written form in easily understood language, and is clear, concise, and supported by documentation.
Skill in analyzing, evaluating, and interpreting a variety of programmatic information.
Skill in problem-solving.
Effective oral and written communication
Work remotely and in the office as needed
Work independently and follow standard operating procedures
Training will be provided.
Experience:
- In reviewing and analyzing documents/information
- With a managed Healthcare organization
- Case management
Qualifications:
High School Diploma or GED