Review Assistant II

The Review Assistant is responsible for inbound and outbound communication in support of case review activities including collection and confirmation of data integrity in support of clinical review services.

This position will report to the Ridgeland, MS office daily.

• Interpret review guidelines to facilitate forward movement of the case review process including requests for clinical information, treatment plans, discharge dates, and communicating the authorization for requested services.
• Coordinate, distribute, and track highly confidential medical information from multiple sources (fax, web, and phone).
• Interpret and adhere to URAC standards for assigned programs as well as federal and state requirements.
• Ensure quality customer service by responding to phone inquiries from members, physicians, and providers.
• Prioritize workload to meet program or regulatory time frames.
• Provide verbal and written communications of review decisions to include administrative denials.
• Complete service/treatment screens for accurate transmission of outcome decisions. 
• Provide general office support and perform miscellaneous duties as assigned.

• High school diploma or equivalent
• 2 years experience working in a customer service or healthcare environment
• Demonstrated ability working with confidential information and in a deadline-driven environment
• Excellent verbal and written communication skills and intermediate PC skills
• Must be able to work daily in the Ridgeland, MS office
• We are unable to consider candidates outside of the United States, candidates in the state of California, or those in US Minor outlying islands and territories.