Claims evaluation and adjudication Analysis, editing and processing of medical claims (CMS 1500 and UB04 forms) Applying set of claim rules to a grouping of claims in a timely manner Adjudicating and escalating process flaws to the Team Leader
Data Entry Specialist (Former Employee) – Bluffton, SC – January 31, 2017
This place really did make me sick. I had to leave because they mico managed everything to even how long you can go to the restroom. My father in law was dyeing and they where not going to let me leave to go and get him from the hospital when he was ready to go home and die. They said if I left I could be fired, I left. You are a number there and nothing else.
I worked there for almost 3 years until finding a job out of my home with a different career path. Considering going back! Loved working from home and having an every other weekend job so I could have 2 days every other week for doctors appointments or taking care of business.
Great benefits, work from home options, good schedule
Strict daily schedule with very structured work day, no room for emergency situations
I thoroughly enjoy my job as a clinical reviewer with Care Core. The management has been great. Its very hard to get that "home" feeling when working in an office in your home, but Care Core did everything they could to help me not feel alone.
Data Entry (Former Employee) – Bluffton, SC – April 10, 2014
This was the absolute worst job I ever had. Management was really rude and inconsiderate. My co-workers were really nice and professional. The hardest part of my job was my supervisor she scrutinize everything I did to the point I felt like I was being harassed. I learned how to work in a really tough environment which I'm very thankful for.
I enjoyed my tenure with the company, but eventually it got to the point where my job was getting redundant and I was not being appreciated enough.
Clinical Decision Support Representative (Former Employee) – Colorado Springs, CO – January 15, 2014
I was with Care Core for almost five years. Only made small raises each year for the great performance I gained. This company was like my second family however, I didn't feel like I was moving forward. I felt like I was stuck in reverse.
I learned a lot from the company though.If it wasn't for this company, I would have not gained the knowledge that I have now. I am thankful for what I have learned.
My Coworkers were great. Like I stated before, they were like my "family", but unfortunately towards the end things were getting very stressful which in turn was affecting the ability to perform my job. I feel like it was repetitive and the employees were not being recognized for what they were doing to better the company.
Pay was decent
Work environment was rather hostile. Under appreciated.
Non - Clinical Mentor (Current Employee) – Bluffton, SC – November 21, 2013
Follow and communicate policy and procedure, URAC and NCQA standards HIPPA compliance, utilize and Implement knowledge of training processes and other Care Core processes, Clinical Certification activities, which include capturing telephone requests for authorization of radiology services from physician offices and or radiology imaging centers; evaluating requests against established clinical protocols and authorizing services or referring request for expert clinical review as appropriate; collecting demographic information and entering data; prepares program correspondence as needed; participation in ongoing training to remain current in performance of focused screening processes; assist in modifications; assist with training new employees; escalate answers to questions to assist coworkers with incoming calls.
Administrative support (Current Employee) – Colorado Springs – October 3, 2013
I spend 8 hours a day speaking with patients, hospital staff and physicians. I provide customer service to each of my callers. Even with working from home, I still work closely with my supervisors and co-workers as a productive team.