Care Management Assistant

Summary: The Care Management Assistant (CMA) supports the Care Management Coordinators with administrative and clerical duties in an effort to meet mandated deadlines relating to utilization review. As the first point of contact for our members, the CMA will be responsible for answering telephone calls, processing faxes, and entering authorization for review. This is a high-volume desk.

Essential Duties and Responsibilities include but are not necessarily limited to the following. Other duties may be assigned.

• Maintain regular office hours.

Administrative & Clerical Duties

• Maintain strict HIPAA Confidentiality; follow all internal policies and procedures to maintain the confidentiality for all members and member data.
• Answer a high volume of telephone calls.
• Provide high quality general administrative services and support to the entire department.
• Work independently on assigned tasks and activities, based on established policies and procedures.
• Receive, log and distribute mail correspondence.
• Manage the department’s email accordingly.
• Handle a variety of basic office tasks such as; filing, faxing, copying, scanning etc.
• Enter requests into the Medical Utilization Review system with accuracy and completeness (99% of the time).
• Adhere to exact deadlines; determination letters must be sent out to the appropriate parties within 24 hours of the medical determination.
• Remain in contact with Care Management staff, other BRMS staff/departments, provider’s offices and members.
• Perform other duties and responsibilities as assigned by the Management.

Knowledge, Skills, & Abilities:

• Strong communication skills, effective and accurate written and verbal form.
• Strong customer service-oriented skills for both internal staff and external clients.
• Strong organizational skills which support timely and well documented action to manage concurrent deadlines and multiple priorities.
• Keyboarding skills and the ability to utilize computer equipment and software are required as is experience with other types of standard office equipment.
• Strong working knowledge of Microsoft Office, excel, windows-based products and software specific to document scanning.
• Medical terminology preferred.
• Ability to work independently and within a team environment.
• Must be able to work within core hours of operation Tuesday-Saturday 800 am - 5:00 pm in the office.

Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience: High School diploma or G.E.D and minimum of one to two years administrative experience within the medical or insurance field; or equivalent and any combination of education, training, and/or experience, which demonstrates ability to perform the duties described.

Language Skills: Ability to read, speak, and write effectively in English. Ability to interpret documents such as safety rules, memos, letters, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively with customers or fellow employees within the organization. Ability to effectively address or resolve customer service issues within guidelines of the position.

Mathematical Skills: Ability to add and subtract, multiply and divide with 10's and 100's.

Supervisory Responsibilities: This job has no supervisory responsibilities.

Certificates, Licenses, Registrations: n/a

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Must be able to sit for extended periods of time; view and input data on PC for extended periods of time. The employee is frequently required to reach with hands and arms and talk or hear. The employee is occasionally required to stand or stoop; walk and use hands to finger, handle, or feel. The employee may frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus.

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.The noise level in the work environment is usually moderate.