CA_CalOptima_CalOptima Health
TEMP - Medical Authorization Assistant
CA_CalOptima_CalOptima Health, Orange, California, United States, 92613
Details
Client Name CA_CalOptima_CalOptima Health Job Type Travel Offering Nursing Profession Certified Medical Assistant (CMA) Specialty Medical Assistant Job ID 15393314 Job Title TEMP - Medical Authorization Assistant Req 493078 Weekly Pay $977.47
Shift Details
Shift Regular 8 Hr Scheduled Hours 40
Job Order Details
Start Date 12/09/2024 End Date 06/06/2025 Duration 26 Week(s)
Job Description CalOptima Health is seeking a highly motivated an experienced TEMP - Medical Authorization Assistant to join our team. The Medical Authorization Assistant (Multipurpose Senior Services Program) will provide office and case management support services. The incumbent will serve as a contact between members, physicians, providers and CalOptima Health's staff to gather information and serve as an interpreter as needed. Under the manager's direction, the incumbent will be responsible for providing effective, efficient and courteous interaction with providers, members and families and other CalOptima Health staff. The incumbent will perform medical administrative and routine tasks specific to the assigned program and may also perform administrative support functions.
Position Information:
- Department: MSSP - Salary Grade: 302 - $23.92 - $33.4880 - Work Arrangement: Full Office
Duties & Responsibilities:
- 80% - Program Support Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Receives cases via fax, phone or electronically and enters new case information into the MSSPCare Online and Jiva systems. Conducts individual interviews/assessments with CalOptima Health members and providers to obtain intake information. Obtains information on requested services according to CalOptima Health's services department guidelines, performs data entry into MSSPCare Online and Jiva and verifies eligibility. Contacts the health networks and CalOptima Health's Customer Service regarding health network enrollments. Assists the Medical Case Managers and Social Workers in gathering medical records, obtaining appropriate information on diagnoses and procedures and following up on phone calls. Documents all contacts and case information in the appropriate MSSPCare Online and Jiva scripts or activity as appropriate. Assists the Medical Case Managers and Social Workers with services arrangement including durable medical equipment and other services and items provided through insurance(s) and community-based organizations. Performs high-volume data entry of 1915(c) Medicaid Waiver services into the MSSPCare online software system, as well as other appropriate databases, for tracking, monitoring, billing and trending of service utilization. - Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. - Receives cases via fax, phone or electronically and enters new case information into the MSSPCare Online and Jiva systems. - Conducts individual interviews/assessments with CalOptima Health members and providers to obtain intake information. - Obtains information on requested services according to CalOptima Health's services department guidelines, performs data entry into MSSPCare Online and Jiva and verifies eligibility. - Contacts the health networks and CalOptima Health's Customer Service regarding health network enrollments. - Assists the Medical Case Managers and Social Workers in gathering medical records, obtaining appropriate information on diagnoses and procedures and following up on phone calls. - Documents all contacts and case information in the appropriate MSSPCare Online and Jiva scripts or activity as appropriate. - Assists the Medical Case Managers and Social Workers with services arrangement including durable medical equipment and other services and items provided through insurance(s) and community-based organizations. - Performs high-volume data entry of 1915(c) Medicaid Waiver services into the MSSPCare online software system, as well as other appropriate databases, for tracking, monitoring, billing and trending of service utilization. - 15% - 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. Generates monthly and other required reports from the databases as requested by the Medical Case Managers, Social Workers and/or health networks. Provides customer service to providers and members. Purchases, delivers and/or retrieves items from vendors and/or MSSP participants as requested by the Medical Case Managers or Social Workers. Conducts in-home visits to retrieve signatures on care plans or other documents. - Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department. - Generates monthly and other required reports from the databases as requested by the Medical Case Managers, Social Workers and/or health networks. - Provides customer service to providers and members. - Purchases, delivers and/or retrieves items from vendors and/or MSSP participants as requested by the Medical Case Managers or Social Workers. - Conducts in-home visits to retrieve signatures on care plans or other documents. - 5% - Completes other projects and duties as assigned.
Minimum Qualifications:
- High School diploma or equivalent required PLUS 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. - Have access to means of transportation for work away from the primary office approximately 5% of the time.
Preferred Qualifications:
- 2 years of experience in invoice reconciliation and medical billing/coding required, preferably for Medicaid/Medi-Cal. - 2 years of experience of data entry completion. - Experience working with the needs of seniors or persons with disabilities (SPD) in a customer/member service capacity. - Bilingual in English and in one of CalOptima Health's 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 CalOptima Health's 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.
If located at PACE:
- Work is typically indoors in a clinical setting serving the frail and elderly. - There may be harmful or hazardous environmental conditions present for this job. - The noise level in this work environment is usually moderate to loud.
If located in the Community:
- Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. - Employee will occasionally work outdoors in varied temperatures. - There may be harmful or hazardous environmental conditions present for this job. - The noise level in this work environment is usually moderate to loud.
About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay!
CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.
CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race.
Client Details
Address 505 City Parkway West City Orange State CA Zip Code 92868
Client Name CA_CalOptima_CalOptima Health Job Type Travel Offering Nursing Profession Certified Medical Assistant (CMA) Specialty Medical Assistant Job ID 15393314 Job Title TEMP - Medical Authorization Assistant Req 493078 Weekly Pay $977.47
Shift Details
Shift Regular 8 Hr Scheduled Hours 40
Job Order Details
Start Date 12/09/2024 End Date 06/06/2025 Duration 26 Week(s)
Job Description CalOptima Health is seeking a highly motivated an experienced TEMP - Medical Authorization Assistant to join our team. The Medical Authorization Assistant (Multipurpose Senior Services Program) will provide office and case management support services. The incumbent will serve as a contact between members, physicians, providers and CalOptima Health's staff to gather information and serve as an interpreter as needed. Under the manager's direction, the incumbent will be responsible for providing effective, efficient and courteous interaction with providers, members and families and other CalOptima Health staff. The incumbent will perform medical administrative and routine tasks specific to the assigned program and may also perform administrative support functions.
Position Information:
- Department: MSSP - Salary Grade: 302 - $23.92 - $33.4880 - Work Arrangement: Full Office
Duties & Responsibilities:
- 80% - Program Support Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Receives cases via fax, phone or electronically and enters new case information into the MSSPCare Online and Jiva systems. Conducts individual interviews/assessments with CalOptima Health members and providers to obtain intake information. Obtains information on requested services according to CalOptima Health's services department guidelines, performs data entry into MSSPCare Online and Jiva and verifies eligibility. Contacts the health networks and CalOptima Health's Customer Service regarding health network enrollments. Assists the Medical Case Managers and Social Workers in gathering medical records, obtaining appropriate information on diagnoses and procedures and following up on phone calls. Documents all contacts and case information in the appropriate MSSPCare Online and Jiva scripts or activity as appropriate. Assists the Medical Case Managers and Social Workers with services arrangement including durable medical equipment and other services and items provided through insurance(s) and community-based organizations. Performs high-volume data entry of 1915(c) Medicaid Waiver services into the MSSPCare online software system, as well as other appropriate databases, for tracking, monitoring, billing and trending of service utilization. - Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. - Receives cases via fax, phone or electronically and enters new case information into the MSSPCare Online and Jiva systems. - Conducts individual interviews/assessments with CalOptima Health members and providers to obtain intake information. - Obtains information on requested services according to CalOptima Health's services department guidelines, performs data entry into MSSPCare Online and Jiva and verifies eligibility. - Contacts the health networks and CalOptima Health's Customer Service regarding health network enrollments. - Assists the Medical Case Managers and Social Workers in gathering medical records, obtaining appropriate information on diagnoses and procedures and following up on phone calls. - Documents all contacts and case information in the appropriate MSSPCare Online and Jiva scripts or activity as appropriate. - Assists the Medical Case Managers and Social Workers with services arrangement including durable medical equipment and other services and items provided through insurance(s) and community-based organizations. - Performs high-volume data entry of 1915(c) Medicaid Waiver services into the MSSPCare online software system, as well as other appropriate databases, for tracking, monitoring, billing and trending of service utilization. - 15% - 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. Generates monthly and other required reports from the databases as requested by the Medical Case Managers, Social Workers and/or health networks. Provides customer service to providers and members. Purchases, delivers and/or retrieves items from vendors and/or MSSP participants as requested by the Medical Case Managers or Social Workers. Conducts in-home visits to retrieve signatures on care plans or other documents. - Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department. - Generates monthly and other required reports from the databases as requested by the Medical Case Managers, Social Workers and/or health networks. - Provides customer service to providers and members. - Purchases, delivers and/or retrieves items from vendors and/or MSSP participants as requested by the Medical Case Managers or Social Workers. - Conducts in-home visits to retrieve signatures on care plans or other documents. - 5% - Completes other projects and duties as assigned.
Minimum Qualifications:
- High School diploma or equivalent required PLUS 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. - Have access to means of transportation for work away from the primary office approximately 5% of the time.
Preferred Qualifications:
- 2 years of experience in invoice reconciliation and medical billing/coding required, preferably for Medicaid/Medi-Cal. - 2 years of experience of data entry completion. - Experience working with the needs of seniors or persons with disabilities (SPD) in a customer/member service capacity. - Bilingual in English and in one of CalOptima Health's 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 CalOptima Health's 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.
If located at PACE:
- Work is typically indoors in a clinical setting serving the frail and elderly. - There may be harmful or hazardous environmental conditions present for this job. - The noise level in this work environment is usually moderate to loud.
If located in the Community:
- Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. - Employee will occasionally work outdoors in varied temperatures. - There may be harmful or hazardous environmental conditions present for this job. - The noise level in this work environment is usually moderate to loud.
About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay!
CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.
CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race.
Client Details
Address 505 City Parkway West City Orange State CA Zip Code 92868