Remote Medical Management Coordinator

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

Benefits offered by this job

Remote Work

Annual bonus

Generous PTO

401(k) with employer match

Tuition reimbursement

Job summary

SCAN Health Plan is seeking a Medical Management Assistant in Los Angeles, CA, to support the Medical Management department. You will respond to provider calls, enter data into CCMS, and authorize services under clinical guidance, ensuring timely information flow for quality care.

The role requires strong data-entry skills, medical terminology knowledge, and Utilization Management experience; familiarity with Medicare/Medi-Cal guidelines is a plus.

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 and CPT coding experience preferred.
• Knowledge of medical terminology required.
• Utilization Management experience required.
• Excellent telephonic communication skills.
• Working knowledge of Medicare and Medi-Cal guidelines preferred.
• Strong organizational skills and ability to multitask.

Responsibilities

• Responds to provider calls and faxes; enters inpatient and related data into the CCMS system.
• Authorizes SCAN services under clinical staff direction; supports department in obtaining required information to ensure quality care.
• Triages events per department guidelines; maintains data entry accuracy and workflow adherence.
• Verifies member data by researching eligibility, benefits, network status, and contracts.
• Maintains professional phone and customer service standards; supports internal/external customers within benefit plan constraints.
• Protects member privacy and SCAN data; follows confidentiality protocols.
• Contributes to team goals; adheres to quality, compliance, and regulatory standards.

Skills

Data entry

Medical terminology

Utilization Management

ICD-9/CPT coding

Phone communication

Education

High School Diploma or equivalent

Associate’s Degree or equivalent experience preferred

Tools

MS Office

Job description

SCAN Health Plan is seeking a Medical Management Assistant in Los Angeles, CA, to support the Medical Management department. You will respond to provider calls, enter data into CCMS, and authorize services under clinical guidance, ensuring timely information flow for quality care.

The role requires strong data-entry skills, medical terminology knowledge, and Utilization Management experience; familiarity with Medicare/Medi-Cal guidelines is a plus.