Clinical Appeals & Medical Case Management Coordinator

Laphcc; Baltimore (MD); Hybrid; USD 30,000 - 47,000; Full time

Job summary

Tech Workforce is seeking a Medical Management Coordinator in Baltimore, hybrid role. You will support the Clinical Appeals and Analysis Unit by handling case entries, records requests, and overturn notices as part of a non-clinical, operational team.

Ideal candidates bring 2 years of healthcare admin experience, familiarity with GuidingCare and Facets, and knowledge of CPT/ICD terminology. On-site 1–2 days weekly, 40 hours, W2 contract for 6 months.

Qualifications

• 2 years of administrative or operational experience within a healthcare environment.
• Familiarity with GuidingCare (Legacy or G6) and Facets platforms.
• Experience with medical coding concepts (CPT/ICD).
• Residency near Canton, with on-site availability 1–2 days per week.

Responsibilities

• Prepare and package full appeal cases and letters for shipment via the on-site mailroom.
• Enter case details into internal systems and create shell cases as needed.
• Review medical records requests and determine documentation needs.
• Draft and print standardized overturn notices and related documents.
• Perform triage of incoming documents for clinical appeals processing.
• Navigate GuidingCare and Facets to access patient and claim data.
• Collaborate with clinical analysts and supervisors to maintain workflow.

Skills

Administrative healthcare experience

GuidingCare

Facets

CPT/ICD terminology familiarity

Tools

GuidingCare

Facets

NASCO

Lotus Notes

Job description

Tech Workforce is seeking a Medical Management Coordinator in Baltimore, hybrid role. You will support the Clinical Appeals and Analysis Unit by handling case entries, records requests, and overturn notices as part of a non-clinical, operational team.

Ideal candidates bring 2 years of healthcare admin experience, familiarity with GuidingCare and Facets, and knowledge of CPT/ICD terminology. On-site 1–2 days weekly, 40 hours, W2 contract for 6 months.