[Remote] Case Management Assistant - Referrals

Note: The job is a remote job and is open to candidates in USA. TRISTAR Insurance Group is seeking a Case Management Assistant to support their case management staff. The role involves monitoring incoming referrals, ensuring they are set up in the system, answering calls, and maintaining referral logs while providing exceptional customer service.

Responsibilities

• Set up of member within the case management system
• Assist incoming calls to the case management referral department
• Monitor dedicated referral emails to review for new referrals and correspondence
• Monitor workflow of referrals and identify areas where daily assistance is needed
• Work with the branch locations and staff to complete and provide necessary information for referrals
• Process all referrals and correspondence within 24 hours of receipt
• Maintain daily/monthly referral logs
• Identify trends and/or issues in referral patterns and communicate them with management
• Demonstrates ability to meet administrative requirements, including productivity, time management and Quality Assurance standards
• Maintain documentation standards adhering to URAC standards and company policy and procedures
• Maintain confidentiality- Knowledge of laws and regulations pertaining to HIPPA and PHI
• Other job duties as assigned

Skills

• High school diploma required
• Experience in healthcare and or managed care related fields
• Strong communication skills; customer service mindset; team player
• Adheres to professional standards, codes of ethics, system and department policies and procedures
• Incorporates the philosophies of continuous quality improvement, customer service and teamwork into daily routine
• Excellent typing and keyboard skills (35-40wpm)
• Ability to work in a variety of computer systems proficiently
• Ability to navigate a Windows environment, utilize Outlook, and the ability to create, edit, save and send documents utilizing Microsoft Word and Microsoft Excel
• Ability to work within a paperless environment
• Knowledge of laws and regulations pertaining to HIPPA and PHI
• Medical or Managed Care background preferred and/ or Certified Medical Assistant
• Minimum of one year of working in a medical or managed care environment preferred
• Medical Terminology preferred

Benefits

• Medical, Dental & Vision Insurance
• Life & Disability Insurance
• 401(k) Plan
• Paid time off
• Paid holiday

Company Overview