Medical Management Assistant (SCAN Temp)
Core
Support the Medical Management department by responding to provider calls, entering inpatient/outpatient data into case management systems, and authorizing SCAN services under clinical direction.
Role type
Medical Management Assistant (Utilization Management)
Builds
Authorization and monitoring of claims for inpatient and outpatient services
Domain
Healthcare / Managed Care / Medicare Advantage
Required skills
Data entry, Medical terminology, Utilization Management, ICD-9/CPT coding, Knowledge of Medicare/Medi-Cal guidelines, Telephonic communication
Preferred skills
Associate's Degree, 3+ years managed care experience, MS Office proficiency
Technologies
CCMS, MS Office
Responsibilities
Respond to provider calls and faxes; Enter inpatient and related data into the case management system; Authorize SCAN services under the direction of clinical staff; Verify member eligibility and benefits; Maintain data entry requirements per departmental policies; Ensure effective working relationships with providers.
Seniority
Individual Contributor, Entry to Mid-level