Kforce Care Review Processor in Syracuse, New York

Kforce has a client in that is seeking a Care Review Processor. This position will be covering Syracuse, NY.Hours: Mon-Fri 8am to 4:45pm Summary: Works within the Care Access and Monitoring (CAM) Team to provide clerical and data entry support for members that require hospitalization and/or utilization review for other healthcare services. Checks eligibility and verifies benefits, obtains and enters data into systems, processes requests, and triages members and information to the appropriate Health Care Services staff to ensure the delivery of high quality, cost-effective healthcare services according to State and Federal requirements to achieve optimal outcomes for members. Provide computer entries of authorization request/provider inquiries by phone, mail, or fax.Duties:

  • Processors will answers calls in queue and assisting with documents (Advanced Imaging, Pregnancy Referrals) going to this company's specific HQ

  • Transmit the information to an inbox and waiting for the return response to help with approval and denial letters.

  • Handle about 20 plus call a day

  • Experience with providers and members

  • Heavy phone usage needed (does not necessarily need to be in a call center)

  • Medical knowledge is preferred

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.Compensation Type:HoursMinimum Compensation:14.00Maximum Compensation:16.00