Medical Case Specialist II- MCO

Who is Leidos QTC Health Services?

Leidos QTC Health Services is the nation’s largest provider of disability and occupational health examination services. We are PASSIONATE about our country’s veterans, UNITED as a team and INSPIRED to make a difference. To provide high-quality, timely, and customer-focused medical examination service solutions, we honor our core values of integrity, innovation, agility, collaboration, inclusion and commitment. We celebrate diverse thinking and welcome contributions from all.

What part would you play in this role?

As a Medical Case Specialist-MCO, you will be the first line of communication working closely with Veterans to ensure appointments are scheduled timely. You will provide internal and external support to stakeholders by providing detailed information.

Typical Day:

• Mon – Fri: 8:00am – 4:30pm CST
• Positions are located ONSITE at our San Antonio, TX location.

Pay and Benefits:

Starting Pay Ranges:

• Level 1 – 0-1 years of experience; $16.20/hr
• Level 2 - 1-3  years of experience; $18.83/hr
• QTRLY Bonuses Available

Pay and benefits are fundamental to any career decision. That's why we craft compensation packages that reflect the importance of the work we do for our customers. As a result, we offer meaningful and engaging careers to support you and your career goals, all while nurturing a healthy work-life balance. Employment benefits include competitive compensation, Health and Wellness programs, Income Protection, Paid Leave and Retirement. More details are available here: Join Our Team | Jobs & Career Opportunities | Leidos QTC Health Services (qtcm.com)

The Leidos QTC Health Services pay range for this job level is a general guideline only and not a guarantee of compensation or salary. Additional factors considered in extending an offer include (but are not limited to): geographic location, responsibilities of the job, education, experience, knowledge, skills, and abilities, as well as internal equity, alignment with market data, applicable bargaining agreement (if any), or other law.

Leidos QTC Health Services. 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, pregnancy, sexual orientation, gender identity, genetic information, people with disabilities protected under law, and protected veteran status.

* 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.

Essential Duties and Responsibilities: 

• Answer phones from automated call distribution system
• 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
• 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:

• High School diploma, or equivalent (GED) 2 years of additional relevant experience in lieu of diploma/GED
• 1 to 3  years of related experience
• healthcare experience preferred
• Experience with electronic medical scheduling and case management software
• Experience with medical coding and knowledge of medical terminology
• Strong computer skills at intermediate level of Microsoft office, especially Excel and Outlook. 
• 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.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)

About the Company:
QTC Management, Inc.