Description

The Data Entry Clerk provides effective coordination by uploading clinical service requests into database. Communicates with IPA and Providers to ensure timely, accessible care/ services to members. Reports directly to the Data Entry Lead under the guidance of the manager. The Data Entry Clerk adheres to MPM company policies and procedures.
Duties and Responsibilities:
Enters referral requests received via fax
Ensures referrals are entered meeting industry timeframes
Verify eligibility and works with eligibility department in maintaining members most current information
Validate CPT and ICD 10 Codes for errors
Outreach to provider for additional member/provider information
Read and maintain email inquiries
Distribute misrouted fax requests according to department
Identify IPA provider network concerns
Sorts and reassigns incoming faxes on right fax
Assist with UM special projects
Assists the Client Support Center with a high volume of calls, as needed
Assists other team members with their workload, as needed
Regular attendance at UM team meetings