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Medical assistant
1 month ago
Hybrid position
- Responsibilities: Performs review of service requests for completeness of information, collection and transfer of non clinical data, and acquisition of structured clinical data from physicians/patients.
- Handles initial screening for pre certification requests from physicians/members via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff.
- Prepare, document, and route cases in the appropriate system for clinical review.
- Initiates call backs and correspondence to members and providers to coordinate and clarify benefits.
- Upon completion of inquiries initiate call back or correspondence to Physicians/Members to coordinate/clarify case completion.
- Education Qualification: High School Diploma required.
- Required Skills: Requires knowledge of medical terminology
- Requires Good Oral and Written Communication skills
- Requires the ability to make sound decisions under the direction of Supervisor
- Prefer knowledge of contracts, enrollment, billing & claims coding/processing
- Prefer knowledge of Managed Care principles
- Prefer the ability to analyze and resolve problems with minimal supervision
- Prefer the ability to use a personal computer and applicable software and systems
- Team Player, Strong Analytical, Interpersonal Skills
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