Medical Management Assistant

Job Summary

Supporting the Medical Management department, the full-time temporary Medical Management Assistant will manage provider communications, enter data into the case management system, and assist clinical staff in authorizing services while working remotely for approximately 3-6 months.

Key responsibilities

• Authorize, monitor, and process claims for inpatient and outpatient services by entering data and triaging events according to departmental guidelines
• Verify member data by researching eligibility, benefits, and provider status while maintaining confidentiality and adhering to privacy standards
• Provide timely and professional support to internal and external customers, ensuring effective communication and collaboration with network providers

Required qualifications

• High School Diploma or equivalent required; Associate's Degree or equivalent experience preferred
• 3+ years of medical experience in a managed care environment preferred
• Proficiency with data entry and knowledge of medical terminology required
• Utilization Management experience is required
• Working knowledge of Medicare and Medi-Cal guidelines preferred