Clinical Data Management-Data Entry Processor

10/26/2006

CLINICAL DATA MANAGEMENT-DATA ENTRY PROCESSOR

Triad Healthcare, Inc. is a national company that assists health plans and employers in the management of patients with pain. We have a proven track record of providing unique solutions for Group Healthcare, Personal Injury (PIP) and Workers’ Compensation (WC) that mitigate risks and optimize healthcare costs.  Our company uses best practices and proprietary software to link payers (carriers), providers (physicians) and patients (members) resulting in operational efficiencies, lower administrative costs and better results for all. 

Triad Healthcare is a growing healthcare company in need of full time Data Entry Processors.  This position is responsible for processing pre-certification requests received from Triad participating providers by applying the policies and procedures for prospective, concurrent scripted review as defined in the Utilization Manual.  The Scripted Reviewer is responsible for the processing of Initial and Extension of Care forms and any and all other documents related to medical management review utilizing specific criteria and procedures while meeting assigned production and accuracy goals as defined in the Utilization Manual.

Primary Responsibilities:

• Image identification and verification
• Data enter HCFA information into claim system
• Process/Data enter authorization information into system
• Forward all Authorizations requiring Clinical/Peer Review to the appropriate staff
• Achieve 100% accuracy in all necessary applications and functions related to the software
• Trainable in the standards of URAC
• Transferring calls relating to clinical determination to Peer Review

Minimum Specifications:

• High School diploma or equivalent
• Knowledge of standard medical terminology or willingness to learn
• Experience in Microsoft Word and Excel (or other Microsoft programs)
• Excellent communication and written skills
• Ability to multitask

Desired Specifications:

• Data entry experience in the medical field

• Understanding of the health care industry

Triad offers excellent compensation and benefits plans that includes Medical, Dental, Vision, 401K and Tuition Assistance.

Triad Healthcare, Inc is an Equal Opportunity Employer.

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