Job Description

Responsible for monitoring, facilitating, and reviewing processes and information to determine if standard procedures set forth were accurately used.

Responsibilities

• Medical Information Review
  
  • Data entry of medical and bill information.
  • Checks data initially entered for accuracy and completeness.
  • Processes client information.
  • Analyzes medical information for appropriateness.
  • Summarizes information to prepare reports as necessary.
  • Conducts quality assurance on processes and documents.
  • Contacts with stakeholders, either through phone call or email to coordinate medical treatment schedule.
  • Approves payments of medical bills.
  • Assists and collaborates with onshore partners in resolving and put claims to closure.
• Finance Information Review
  
  • Act as the point of contact in the absence of a Team Lead or Supervisor
  • Handle complex scenarios that would require further analysis and decision making (I.e., Client account reconciliation, billing history, etc.)
  • Processes client information.
  • Ensure the accuracy of financial data that is provided both internally and externally.
  • Summarizes information to prepare reports as necessary and be able to explain these financial reports.
  • Conducts quality assurance on processes and documents.
  • Facilitates any additional training needed by the team.
• Business Process Support
  
  • Analyzes and resolves any issues and inquiries regarding matters of work in a customer-oriented approach.
  • Routes tasks to appropriate processor by utilizing internal systems.
  • Refers matters beyond limits of authority and expertise to immediate superior for direction.
  • Upholds the Crawford Code of Conduct by protecting the confidentiality of information.
  • Adheres to the standard operating procedures (SOP) and turnaround time set by the company.
  • Performs variety of administrative duties and other related tasks from time to time as assigned to contribute to other business processes.

Qualifications

• Bachelor's Degree or equivalent professional experience in lieu of a degree
• At least two (2) years related work experience.
• Must:
  
  • Proficient typing skills.
  • Good communication skills.
  • Proficient in word processing and spreadsheet softwares.
  • High analytical skills in reviewing medical information or financial information.
• Desired:
  
  • Competence in case management outcomes.
  • Knowledge and understanding of QI and QA practices.
• Ability to multi-task, prioritize and manage time effectively.
• Keen attention to details in order to produce quality output.
• Maintains high degree of professionalism and confidentiality.
• Interpersonal skills - Able to work independently and as a team member.