Medical Assistant

About the Role: Client is seeking a highly motivated an experienced TEMP - Medical Authorization Assistant (CCR) (RTF 006) to join our team.

The Medical Authorization Assistant (Concurrent Review) will provide office and referral management support services, assist the inpatient Medical Case Managers in obtaining medical records, document all case information in the system, perform data entry into appropriate databases for monitoring and tracking and follow up on phone calls as directed by the Medical Case Managers. The incumbent will serve as the contact between members, physicians, facilities, providers and Client staff. The incumbent will be responsible for processing the intake information and assisting with authorization functions.

The incumbent will also perform office support functions as needed. Qualifications: High School diploma or equivalent required. 2 years of experience in a health care or managed care setting required. An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

Required Skills: Previous medical billing and coding experience. Certified medical assistant (CMA) certification . Concurrent review and utilization management experience.

Bilingual in English and in one of Client's defined threshold languages (Arabic, Farsi, Chinese, Korean, Spanish, Vietnamese). Responsibilities: 85% Medical Authorization Receives referral requests via fax, phone or electronically and enters new service request information into the authorization system. Collects additional information from Client members and providers to complete referral information.

Authorizes requested services according to Client’s authorization guidelines, performing data entry into the authorization system and verifying eligibility.

Contacts the health networks and Client Customer Service regarding health network enrollments. Assists the Medical Case Managers in gathering medical records, obtains appropriate coding for diagnosis and procedures and follows up on phone calls as directed by the authorization nurse.

Documents all contacts and case information in the system using the standard charting format.

Performs data entry into the appropriate databases for monitoring, tracking and trending of events and other relevant databases as needed. Receives referral requests via fax, phone or electronically and enters new service request information into the authorization system. Collects additional information from Client members and providers to complete referral information.

Authorizes requested services according to Client’s authorization guidelines, performing data entry into the authorization system and verifying eligibility.

Contacts the health networks and Client Customer Service regarding health network enrollments. Assists the Medical Case Managers in gathering medical records, obtains appropriate coding for diagnosis and procedures and follows up on phone calls as directed by the authorization nurse.

Documents all contacts and case information in the system using the standard charting format.

Performs data entry into the appropriate databases for monitoring, tracking and trending of events and other relevant databases as needed. 10% Administrative Support Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Assists the team in carrying out department responsibilities and collaborates with others to support shortand long-term goals/priorities for the department. 5% Completes other projects and duties as assigned.