Medical Case Specialist I-Nashville Details

Medical Case Specialist I-Nashville

QTC Management, Inc. - Nashville, TN

Employment Type : Full-Time

Job Summary:

Under limited supervision, performs a variety of activities in support of a specific project/business/technical unit. Gathers, collects, records, tracks and verifies data and information from multiple sources. Uses software for functional area to schedule appointments and document in the case management systems. Compiles and generate reports, statistics, timelines, tables, graphs, correspondence and presentations. Provides data and information to others on functional unit processes and procedures. Delivers exceptional customer service at all customer touch points.

Essential Duties and Responsibilities:

• Answer phones from automated call distribution system
• Triage daily download of referrals and ensure appropriate worksheets are assigned to corresponding conditions as identified by Veteran’s Administration
• Verify appropriate CPT and CLIN codes are assigned to each case
• Communicate directly with claimants and providers
• Obtain medical history for specific conditions
• Determine appropriate examinations, tests and specialists required for each case
• Schedule appointments for examinees including follow-up appointments and rescheduled appointments
• Ensure all examinees and providers receive necessary documentation
• Confirm consultative reports and diagnostic test results are received in a timely manner
• Meet or exceed contract timeliness guidelines in both the scheduling and case management systems
• Other projects and duties as assigned

Competencies:

• Proven ability to plan and organize work load
• Ability to manage competing priorities in a fast paced work environment
• Good follow through skills
• Must possess the ability and flexibility to work early morning, evening, and/or weekend shifts

Education and/or Experience:

• Must be able to successfully pass National Agency Check with Inquiries (NACI) background investigation

This job description supersedes all prior job descriptions and is intended to describe the general content and essential requirements for the position listed above. It is not to be construed as an exhaustive statement of requirements, duties and responsibilities. Management reserves the right to add or change the duties of this position as required at any time.

QTC Management Inc. is a VEVRAA Federal contractor and an Equal Opportunity Employer. The company has an ongoing commitment to affirmative action and the creation of a workplace free of discrimination, harassment and retaliation. The company recruits, hires, trains, and promotes individuals in all job titles without regard to race, color, creed, religion, ancestry, national origin, age, sex, sexual orientation, people with disabilities protected under law, and protected veteran status.