Medical Management Coordinator

Job Title: Medical Management Coordinator
Location: Baltimore, Maryland
Type: Contract - 6 months
Compensation: $27.27
Work Model: Hybrid – onsite and remote
Hours: 40.0 hours per week

Responsibilities

• Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks related to pre-service, utilization review, care coordination, and quality of care.
• Performs member or provider related administrative support, including benefit verification, authorization creation and management, claims inquiries, and case documentation.
• Reviews authorization requests for initial determination and/or triages for clinical review and resolution.
• Provides general support and coordination services for the department, including answering and responding to telephone calls, taking messages, handling correspondence, researching information, and assisting in problem-solving.
• Assists with reporting, data tracking, gathering, organization, and dissemination of information such as Continuity of Care process and tracking of Peer to Peer reviews.

Requirements

• High School Diploma
• Minimum of 3 years experience in health care claims/service areas or office support
• On-site mailing Canton Office
• Knowledge of CPT and ICD-10 coding
• Ability to effectively participate in a multi-disciplinary team including internal and external participants
• Excellent communication, organizational, and customer service skills
• Knowledge of basic medical terminology and concepts used in managed care
• Knowledge of standardized processes and procedures for evaluating medical support operations business practices
• Excellent independent judgment and decision-making skills, demonstrating tact and diplomacy
• Attention to detail in project or task management
• Experienced in the use of web-based technology and Microsoft Office applications such as Word, Excel, and PowerPoint

System One, and its subsidiaries including Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

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Ref: #851-Rockville-S1