PHP Fax/Callout Clerk
PHP Fax/Callout Clerk Job Description >Job Code: NI9604N Purpose/Scope of Position: The role of the PHP Clerk is to support the PHP department by attaching faxes to existing requests for prior authorization and making out bound calls to ordering physicians offices to request additional clinical information be faxed to NIA for review by clinical staff.
Responsibilities/Duties: * Attach faxes to existing requests for prior authorization.
* Make out bound calls to the ordering physicians office to request additional clinical information be faxed to NIA. * Transfer ordering physician or office staff to PCR for peer to peer discussion as appropriate.
* Notify Lead PHP rep or PHP supervisor if no existing case is located in Informa for fax information received.
* Meet department benchmarks for assigned duties.
* Participate in the Utilization Management and Quality Management programs as directed.
* Practice and maintain the principles of utilization management of adhering to NIA policies and procedures * Additional duties as assigned Knowledge, Skills & Abilities: * Must possess excellent interpersonal skills, verbal communication skills, organizational skills and attention to detail required.
* Medical terminology preferred Education & Experience: * High School diploma or GED required * Experience with automated databases and standard PC business software applications preferred * 6 months of experience in a healthcare setting (hospital, physician office, health plan) preferred.
* 6 months of experience as a customer service representative in a health care setting or multi-function call center preferred
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