Healthcare Call Center

• Process cases through CMS and client portals by entering, reviewing, and verifying eligibility and case information.
• Retrieve medical records from external client systems and upload documentation into internal databases.
• Review records and supporting documentation for completeness, accuracy, and compliance.
• Prepare, enter, track, and maintain case information across multiple systems and databases.
• Respond to client inquiries regarding case status, reports, documentation requirements, and general requests.
• Communicate with internal teams regarding pending reports, case progress, and workflow updates.
• Coordinate with physicians, providers, and clinicians to assign cases and obtain required documentation.
• Monitor case timelines and ensure information is accurately documented and updated.
• Support the Independent Dispute Resolution (IDR) process by reviewing documentation before clinical review.
• Maintain confidentiality and comply with HIPAA, CMS requirements, and company policies.
• Perform data entry, filing, documentation management, and administrative support functions.

Requirements

• High school diploma or equivalent.
• Strong data entry and administrative experience.
• Excellent attention to detail and document review skills.
• Strong written and verbal communication abilities.
• Ability to navigate multiple systems and databases simultaneously.
• Comfortable working with medical records, insurance documentation, and confidential information.
• Strong computer skills and proficiency with Microsoft Office applications.
• Reliable internet connection and a private workspace suitable for remote work.
• Demonstrated ability to manage deadlines and maintain accuracy in a high-volume environment.
• Previous experience in healthcare, insurance, utilization review, medical records, claims processing, or case coordination preferred.
• Experience reviewing contracts, legal documents, or detailed reports preferred.
• Familiarity with CMS portals, eligibility verification, or healthcare administrative processes preferred.
• Experience working with regulatory and compliance-driven documentation preferred.
• Knowledge of HIPAA and healthcare privacy requirements preferred.

Core Competencies

Demonstrates strong data entry and administrative skills while ensuring compliance with HIPAA and CMS requirements. Proficient in managing case information across multiple systems and maintaining accuracy in a high-volume healthcare environment.

Highest-signal resume keywords

• Data Entry
• Document Review
• Microsoft Office Proficiency
• HIPAA Compliance
• Healthcare Administrative Processes

Hard Skills

• Data Entry
• Document Review
• Case Coordination
• Eligibility Verification
• Claims Processing
• Medical Records Management
• Regulatory Compliance
• Administrative Support
• Attention to Detail
• High-Volume Accuracy

Soft Skills

• Written Communication
• Verbal Communication
• Time Management
• Client Interaction
• Team Collaboration

Industry Keywords

• Healthcare
• Insurance
• Utilization Review
• Confidential Information
• Compliance-Driven Documentation

Tools & Technologies

• CMS Portals
• Client Portals
• Internal Databases
• External Client Systems
• Documentation Management Systems