The Midtown Group
Medical Authorization Assistant
The Midtown Group, Orange, California, United States, 92613
Hourly Rate: $23.92 - $33.48/hrOffer will be made by the client based on experience and on their internal scale!
Fully In-officeHigh School diploma or equivalent required.2 years of experience in a health care or managed care setting required.
Job Summary
One of our most prestigous healthcare clients 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 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.
Position Information:
Duties & Responsibilities:
- 85% - Medical Authorization Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Receives inpatient requests via fax, phone or electronically and enters data of new case information into the medical management system. Creates inpatient events based on facility face sheets and/or clinical received. Verifies member eligibility. Collects additional information from members and/or providers/facilities to complete prospective, concurrent or retrospective inpatient service reviews. Authorizes requested services according to Concurrent Review team guidelines. Contacts the health networks and/or the Customer Service department regarding health network enrollments. Assists the inpatient Medical Case Manager in gathering medical records, obtaining appropriate coding for diagnosis and procedures, discharge dates, dispositions and conducts follow-up phone calls per concurrent review team standards.- Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.- Receives inpatient requests via fax, phone or electronically and enters data of new case information into the medical management system.- Creates inpatient events based on facility face sheets and/or clinical received.- Verifies member eligibility.- Collects additional information from members and/or providers/facilities to complete prospective, concurrent or retrospective inpatient service reviews.- Authorizes requested services according to the Concurrent Review team guidelines.- Contacts the health networks and/or the Customer Service department regarding health network enrollments.- Assists the inpatient Medical Case Manager in gathering medical records, obtaining appropriate coding for diagnosis and procedures, discharge dates, dispositions and conducts follow-up phone calls per concurrent review team standards.- 10% - Administrative Support Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department. Documents all contacts and case information in the system using the standard charting format. Enters data into the appropriate databases for monitoring and tracking, trending of inpatient events and other relevant databases as needed.- Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.- Documents all contacts and case information in the system using the standard charting format.- Enters data into the appropriate databases for monitoring and tracking, trending of inpatient events and other relevant databases as needed.- 5% - Completes other projects and duties as assigned.
Minimum 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.
Preferred Qualifications:
- Previous medical billing and coding experience.- Certified medical assistant (CMA) certification.- Concurrent review and utilization management experience.- Bilingual in English and in one of the defined threshold languages (Arabic, Farsi, Chinese, Korean, Spanish, Vietnamese).
Required Licensure / Certifications:
- N/A
Knowledge & Abilities:
- Develop rapport and establish and maintain effective working relationships with leadership and staff and external contacts at all levels and with diverse backgrounds.- Work independently and exercise sound judgment.- Communicate clearly and concisely, both orally and in writing.- Work a flexible schedule; available to participate in evening and weekend events.- Organize, be analytical, problem-solve and possess project management skills.- Work in a fast-paced environment and in an efficient manner.- Manage multiple projects and identify opportunities for internal and external collaboration.- Motivate and lead multi-program teams and external committees/coalitions.- Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Physical Requirements (With or Without Accommodations):
- Ability to visually read information from computer screens, forms and other printed materials and information.- Ability to speak (enunciate) clearly in conversation and general communication.- Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.- Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.- Lifting and moving objects, patients and/or equipment 10 to 25 pounds
Work Environment:
If located at the 500, 505 Building or a remote work location:
- Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.- There are no harmful environmental conditions present for this job.- The noise level in this work environment is usually moderate.
The Midtown Group is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. We are a small, woman-owned business certified by the Women's Business Enterprise National Council (WBENC). Operating from our headquarters in Washington, DC, we provide trusted staffing services nationwide. Our clients include thousands of the most prestigious Fortune 500 companies, law firms, financial organizations, tech innovators, non-profits, and lobbying firms, as well as federal, state and local government agencies.
Fully In-officeHigh School diploma or equivalent required.2 years of experience in a health care or managed care setting required.
Job Summary
One of our most prestigous healthcare clients 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 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.
Position Information:
Duties & Responsibilities:
- 85% - Medical Authorization Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Receives inpatient requests via fax, phone or electronically and enters data of new case information into the medical management system. Creates inpatient events based on facility face sheets and/or clinical received. Verifies member eligibility. Collects additional information from members and/or providers/facilities to complete prospective, concurrent or retrospective inpatient service reviews. Authorizes requested services according to Concurrent Review team guidelines. Contacts the health networks and/or the Customer Service department regarding health network enrollments. Assists the inpatient Medical Case Manager in gathering medical records, obtaining appropriate coding for diagnosis and procedures, discharge dates, dispositions and conducts follow-up phone calls per concurrent review team standards.- Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.- Receives inpatient requests via fax, phone or electronically and enters data of new case information into the medical management system.- Creates inpatient events based on facility face sheets and/or clinical received.- Verifies member eligibility.- Collects additional information from members and/or providers/facilities to complete prospective, concurrent or retrospective inpatient service reviews.- Authorizes requested services according to the Concurrent Review team guidelines.- Contacts the health networks and/or the Customer Service department regarding health network enrollments.- Assists the inpatient Medical Case Manager in gathering medical records, obtaining appropriate coding for diagnosis and procedures, discharge dates, dispositions and conducts follow-up phone calls per concurrent review team standards.- 10% - Administrative Support Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department. Documents all contacts and case information in the system using the standard charting format. Enters data into the appropriate databases for monitoring and tracking, trending of inpatient events and other relevant databases as needed.- Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.- Documents all contacts and case information in the system using the standard charting format.- Enters data into the appropriate databases for monitoring and tracking, trending of inpatient events and other relevant databases as needed.- 5% - Completes other projects and duties as assigned.
Minimum 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.
Preferred Qualifications:
- Previous medical billing and coding experience.- Certified medical assistant (CMA) certification.- Concurrent review and utilization management experience.- Bilingual in English and in one of the defined threshold languages (Arabic, Farsi, Chinese, Korean, Spanish, Vietnamese).
Required Licensure / Certifications:
- N/A
Knowledge & Abilities:
- Develop rapport and establish and maintain effective working relationships with leadership and staff and external contacts at all levels and with diverse backgrounds.- Work independently and exercise sound judgment.- Communicate clearly and concisely, both orally and in writing.- Work a flexible schedule; available to participate in evening and weekend events.- Organize, be analytical, problem-solve and possess project management skills.- Work in a fast-paced environment and in an efficient manner.- Manage multiple projects and identify opportunities for internal and external collaboration.- Motivate and lead multi-program teams and external committees/coalitions.- Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Physical Requirements (With or Without Accommodations):
- Ability to visually read information from computer screens, forms and other printed materials and information.- Ability to speak (enunciate) clearly in conversation and general communication.- Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.- Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.- Lifting and moving objects, patients and/or equipment 10 to 25 pounds
Work Environment:
If located at the 500, 505 Building or a remote work location:
- Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.- There are no harmful environmental conditions present for this job.- The noise level in this work environment is usually moderate.
The Midtown Group is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. We are a small, woman-owned business certified by the Women's Business Enterprise National Council (WBENC). Operating from our headquarters in Washington, DC, we provide trusted staffing services nationwide. Our clients include thousands of the most prestigious Fortune 500 companies, law firms, financial organizations, tech innovators, non-profits, and lobbying firms, as well as federal, state and local government agencies.