Remote Medical Management Coordinator

SCAN Health Insurance; United States; Remote; USD 28,000 - 38,000; Full time

Benefits offered by this job

Remote Work Mode

Annual employee bonus program

Wellness Program

PTO

11 holidays + floating + birthday

Job summary

SCAN Health Insurance is seeking a remote, temporary support specialist to assist the Medical Management department. The role involves responding to provider calls, data entry into the CCMS system, and authorizing services under clinical guidance.

You will verify eligibility, process claims, and communicate with members, while upholding privacy and regulatory standards. Eligible candidates have 3+ years in managed care and strong data-entry skills.

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 telephonic communication skills.

Responsibilities

• Respond to provider calls and faxes; enter data into CCMS; authorize SCAN services under clinical staff direction.
• Process inpatient/outpatient claims by entering data per department guidelines.
• Verify member data by researching eligibility, benefits, network status, and DOFR.
• Maintain telephone standards by answering calls within established times.
• Develop collaborative relationships with network providers; ensure services fit benefit plans.
• Protect member privacy and SCAN operations; maintain confidentiality.
• Communicate with members and caregivers with courtesy and respect.
• Comply with quality, compliance, and regulatory standards.

Skills

Excellent communication

Data entry

Utilization Management

Medicare/Medi-Cal knowledge

Telephonic communication

Multitasking

Organizational skills

MS Office proficiency

Education

High School Diploma

Associate's Degree or equivalent

Tools

MS Office

Job description

SCAN Health Insurance is seeking a remote, temporary support specialist to assist the Medical Management department. The role involves responding to provider calls, data entry into the CCMS system, and authorizing services under clinical guidance.

You will verify eligibility, process claims, and communicate with members, while upholding privacy and regulatory standards. Eligible candidates have 3+ years in managed care and strong data-entry skills.