Remote Medical Management Assistant

SCAN; Los Angeles (CA); Remote; USD 28,000 - 38,000; Full time

Benefits offered by this job

Base hourly pay $20.14–$27.77

Remote Work Mode

Annual bonus program

Wellness Program

PTO

Holidays & birthday holiday

401(k) with employer match

Employee recognition program

Tuition reimbursement

Impactful team helping members

Job summary

SCAN, a nonprofit health organization, seeks an experienced Medical Management Support professional for a remote role in the U.S. Pacific Time zone. You will respond to provider calls, enter data into CCMS, and process authorizations and claims under clinical guidance.

Responsibilities include verifying eligibility, maintaining data accuracy, and supporting network providers while upholding privacy and compliance standards in a fast-paced environment.

Qualifications

• High School Diploma or equivalent is required; an Associate’s degree or equivalent experience is preferred.
• 3+ years of medical experience in a managed care environment is preferred.
• Proficiency with data entry is required.
• ICD-9, CPT coding experience is preferred.
• Knowledge of medical terminology is required.
• Utilization Management experience is required.
• Excellent communication skills, primarily telephonic.
• MS Office proficiency is required.
• Medicare and Medi-Cal guidelines knowledge is preferred.

Responsibilities

• Respond to provider calls and faxes; enter inpatient data into CCMS and authorize services under clinical staff direction.
• Support authorization, monitoring and processing of claims by entering data and triaging events.
• Maintain data entry workflows and adherence to departmental policies.
• Verify member data by researching eligibility, benefits, and provider status.
• Answer calls within established turnaround times and support internal/external customers.
• Collaborate with network providers to ensure services are within the benefit plan.
• Maintain privacy and confidentiality of member information.
• Follow department procedures and training materials; identify barriers and report to supervisor.

Skills

Data entry

Medical terminology

Utilization management

Communication

MS Office

Multitasking

Organization

Customer service

Phone/telephonic skills

Education

High School Diploma or equivalent

Associate’s Degree or equivalent experience

Tools

MS Office

Job description

SCAN, a nonprofit health organization, seeks an experienced Medical Management Support professional for a remote role in the U.S. Pacific Time zone. You will respond to provider calls, enter data into CCMS, and process authorizations and claims under clinical guidance.

Responsibilities include verifying eligibility, maintaining data accuracy, and supporting network providers while upholding privacy and compliance standards in a fast-paced environment.