Dynamic Clinical Care Reviewer at AmeriHealth Caritas, adept at enhancing document accuracy and confidentiality. Proven ability to streamline processes, reducing review turnaround time. Skilled in effective communication and detail-oriented analysis, contributing to a robust knowledge base for efficient problem-solving. Committed to delivering high-quality service in fast-paced environments.
Evaluates the inquiry while focusing on the severity of the illness and integrity of service to facilitate the patients smooth transition to the nursing center.
Works with Relay Clearance , Navinet and Interqual system.
Processes inquires received either electronically or via fax, at a minimum rate of 5-15 inquires per day
Obtains accurate information from physicians, patient and/or responsible party
Focused on converting inquires to admissions
Addresses and seeks to work collaboratively with center to resolve customer service issues with family and referral services