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Review Assistant III
Review Assistant IIITelligen • West Des Moines, IA, United States
Review Assistant III

Review Assistant III

Telligen • West Des Moines, IA, United States
13 days ago
Job type
  • Full-time
Job description

As a Review Assistant III , you will be responsible for providing advanced support for the medical review process, ensuring medical information is received, documented, maintained and distributed to appropriate team members in a confidential manner for activities to be completed appropriately and within required timeframes.

This role requires an in-office presence one day per month at the West Des Moines office.

Essential Functions

  • You will ensure data integrity by performing data entry of information received from various sources.
  • You will gather, coordinate, distribute, track and maintain highly confidential medical records according to Company, contract and / or federal / state regulations.
  • You will mentor and orient other review assistants, manage support task workflow including coordinating workload with other assistants.
  • You will escalate issues through appropriate channels, following established hierarchical protocols between clinical and non-clinical staff members.
  • You will provide advanced office support for team and / or department which may include creating and editing documents, answering phones, responding to questions, distributing documents or reports and managing claims information.
  • You will ensure quality customer service by responding to phone inquiries from members, physicians, and providers.
  • You will prioritize workload to meet program or regulatory time frames.
  • You will effectively guide members to appropriate member benefit information.

Requirements

  • High school diploma or general education degree (GED)
  • 2 years related experience and / or training in medical terminology / transcription; or equivalent combination of education and experience.
  • Preferred Skills

  • Medical terminology
  • Prior Authorization
  • Medical Necessity
  • Appeals
  • Peer to Peer
  • URAC / NCQA
  • Who We Are :

    Telligen is one of the most respected population health management organizations in the country. We work with state and federal government programs, as well as employers and health plans offering clinical, analytical, and technical expertise.

    Over our 50-year history, health care has evolved - and so have we. What hasn't changed is our deep commitment to those we serve. Our success is built on our ability to adapt, respond to client needs and deliver innovative, mission-driven solutions.

    Our business is our people and we're seeking talented individuals who share our passion and are ready to take ownership, make an impact and helth shape the future of health.

    Are you Ready?

    We're on a mission to transform lives and economies by improving health.

    Ownership : As a 100% employee-owned company, our employee-owners drive our business and share in our success.

    Community : We show up - for our clients, our communities and each other. Being a responsible corporate partner is part of who we are.

    Ingenuity : We value bold ideas and calculated risks. Innovation thrives when we challenge the status quo and listen to diverse perspectives.

    Integrity : We foster a respectful, inclusive, and collaborative environment built on trust and excellence.

    Thank you for your interest in Telligen!

    Follow us on Twitter, Facebook, and LinkedIn to learn more about our mission-driven culture and stay up to speed.

    While we use artificial intelligence tools to enhance our initial screening process, all applications are thoroughly reviewed by our human recruitment team to ensure a fair and comprehensive evaluation of each candidate.

    Telligen and our affiliates are Equal Opportunity Employers and E-Verify Participants.

    Telligen will not provide sponsorship for this position. If you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time. We will not accept 3rd party solicitations from outside staffing firms.

    We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

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    Review Assistant Iii • West Des Moines, IA, United States

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