Remote Medical Management Assistant - Data & Authorization

SCAN Group; Long Beach (CA); Remote; USD 2,774,000 - 3,826,000; Full time

Benefits offered by this job

Remote Work Mode

Annual bonus program

Wellness Program

Paid time off

Job summary

SCAN Group is seeking a remote role professional to support the Medical Management department by handling provider calls, data entry into CCMS, and authorizing services under clinical guidance. You will assist in processing inpatient and outpatient claims and verifying member eligibility while maintaining privacy.

The role emphasizes strong communication, utilization management experience, and the ability to work independently in a fast-paced environment.

Qualifications

• High School Diploma or equivalent required; Associate's Degree or equivalent experience preferred.
• 3+ years of medical experience in a managed care environment preferred.
• Proficiency with data entry required.
• ICD-9, CPT coding experience preferred.
• Knowledge of medical terminology required.
• Utilization Management experience required.
• Excellent communication skills; primarily telephonic required.
• Working knowledge of Medicare and Medi-Cal guidelines preferred.
• Strong organizational skills and the ability to prioritize.
• Ability to multitask in a fast-paced environment.
• Proficient in MS Office.

Responsibilities

• Respond to provider calls and faxes; enter inpatient and related data into the case management system (CCMS).
• Authorize SCAN services under clinical supervision.
• Support Medical Management staff in securing information for quality care delivery.
• Process and monitor claims for inpatient and outpatient services; triage events per guidelines.
• Verify member data and eligibility; maintain privacy and confidentiality.
• Maintain telephone standards and provide service to internal and external customers.
• Develop collaborative relationships with network providers.

Skills

Data entry

Communication skills

MS Office

Medical terminology

Utilization Management

Education

High School Diploma or equivalent

Associate's Degree or equivalent experience

Tools

CCMS

Job description

SCAN Group is seeking a remote role professional to support the Medical Management department by handling provider calls, data entry into CCMS, and authorizing services under clinical guidance. You will assist in processing inpatient and outpatient claims and verifying member eligibility while maintaining privacy.

The role emphasizes strong communication, utilization management experience, and the ability to work independently in a fast-paced environment.