Job Description
Our client, a Health Insurance company, is looking for a Medical Management Coordinator for their Baltimore, MD location.
Responsibilities:
Requirements:
Why Should You Apply?
#alljobs
#mcb
Responsibilities:
- Assist analyst with triaging and entering appeals; this includes printing and assisting with medical records request and create overturn notices.
- Assist with creating shell cases in GuidingCare and create appeal letters.
- Intake and case build; screen all channels daily, return misroutes, confirm member/claim data, and queue clean cases oldest-first.
- Record retrieval: Issue and track both requests on a fixed cadence, call provider offices on day 3, and index documents in GuidingCare/SharePoint; only non-responsive providers escalate.
- Prepare MD and IRO packets and track vendor due dates.
- Closure and notification: Route decisions, generate and mail letters and FFRNs, monitor the adjustment queue, and notify providers the day the decision is made.
Requirements:
- Knowledge of CPT and ICD-10 coding, Claims, GuidingCare, Facets Legacy and G6.
- Minimum 2 years’ experience in health care/managed care setting
- Previous appeals, ability to review letter of appeal, identify claims.
- Nasco experience is a plus.
Why Should You Apply?
#alljobs
#mcb
Numbers & Facts
| Location | Baltimore, MD |
| Industry | Management Consulting Services |
| Salary | $24.27–$27.27 Per Hour |
| Company Size | 2,000 to 2,499 employees |
| Year Founded | 2000 |
| Website | https://www.iconma.com/ |
Benefits
401K, Employee Referral Program, Life Insurance
About Company
ICONMA is a global information consulting management firm providing Professional Staffing Services and Project-Based Solutions for organizations in a broad range of industries.
- Corporate Headquarters in Troy, Michigan; 20+ locations worldwide.
- Certified Woman-Owned Business Enterprise (WBE); certified by Women’s Business Enterprise National Council, National Women Business Owners Corporation (NWBOC); and California Public Utilities Commission (CPUC).
- Founded in 2000
- 2000+ Employees
The company was founded on the principle that success is derived from delivering high quality service and resources in the most responsive, flexible, and innovative way. ICONMA invests in people and resources with a single goal: To provide our customers with the highest quality service in the most responsive manner. Through its network of offices, ICONMA provides the resources to help clients maintain their competitive advantage.
Skills
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