Job Description Required Education: High School DiplomaRequired Qualifications/Skills/Experience: Call Center Adjudicating Claims Medicaid claims Prior authorizations for medical claims Data Entry Experience with Microsoft Word and with Basic Excel functions Proficient in the use of standard office technology, to include fax machines, document scanners and copiersAuditor Job Duties: Answering telephone inquiries from healthcare providers, members caregivers and advocacy groups related to prior approval of medical services such as durable medical equipment, medical supplies, hearing aids, private duty nursing and out of state inquiries involving nursing home placement and other out of state procedures. Escalating complex inquires that cannot be answered with available information to appropriate staff Guiding and educating providers, as well as members, on where to locate pertinent policy information Assisting providers to troubleshoot our prior approval system(s) Performing data entry into excel spreadsheets and other tracking tools Monitoring incoming emails and/or faxes from a shared mailbox and forward to the appropriate staff. Sending faxes through e-mail supported fax mailbox Supporting claims processing when other duties are finished Maintaining a positive and professional demeanor always All other activities as may be deemed necessary
- **Only those lawfully authorized to work in the designated country associated with the position will be considered.**
- **Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.**
Benefits: For information and details on employment benefits offered with this position, please visit here . Should you have any questions/concerns, please contact our HR Department via our secure website . California Pay Equity: For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here . Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances. If you need assistance in completing this application, or during any phase of the application, interview, hiring, or employment process, whether due to a disability or otherwise, please contact our HR Department . Rose International has an official agreement (ID #132522), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13/10-91.).