Medical Authorization Assistant

Details

Client NameCA_CalOptima_CalOptima HealthJob TypeTravelOfferingNursingProfessionCertified Medical Assistant (CMA)SpecialtyMedical AssistantJob ID16011998Job TitleMedical Authorization AssistantWeekly Pay$1100.2

Shift Details

Shift08 : 00 AM - 05 : 00 PMScheduled Hours45

Job Order Details

Start Date02 / 11 / 2025End Date05 / 13 / 2025Duration13 Week(s)

Job DescriptionDue Date - Feb-10-2025

Submission Information :

• The deadline to be guaranteed full review of your submission is due by Monday, February 10, 2025 by 9 : 00 p.m. PST. This position will remain open for a minimum of seven (7) days, but may be extended if a lack of qualified applicants are received or if we are hiring multiple positions.Duties & Responsibilities :
• 80% - - Program SupportoParticipates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.oReceives cases via fax, phone or electronically and enters new case information into the MSSPCare Online and Jiva systems.oConducts individual interviews / assessments with CalOptima Health members and providers to obtain intake information.oObtains information on requested services according to CalOptima Health's services department guidelines, performs data entry into MSSPCare Online and Jiva and verifies eligibility.oContacts the health networks and CalOptima Health's Customer Service regarding health network enrollments.oAssists the Medical Case Managers and Social Workers in gathering medical records, obtaining appropriate information on diagnoses and procedures and following up on phone calls.oDocuments all contacts and case information in the appropriate MSSPCare Online and Jiva scripts or activity as appropriate.oAssists the Medical Case Managers and Social Workers with services arrangement including durable medical equipment and other services and items provided through insurance(s) and community-based organizations.oPerforms high-volume data entry of 1915(c) Medicaid Waiver services into the MSSPCare online software system, as well as other appropriate databases, for tracking, monitoring, billing and trending of service utilization.
• 15% - Administrative SupportoAssists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals / priorities for the department.oGenerates monthly and other required reports from the databases as requested by the Medical Case Managers, Social Workers and / or health networks.oProvides customer service to providers and members.oPurchases, delivers and / or retrieves items from vendors and / or MSSP participants as requested by the Medical Case Managers or Social Workers.oConducts in-home visits to retrieve signatures on care plans or other documents.
• 5% - Completes other projects and duties as assigned.Minimum Qualifications :
• High School diploma or equivalent required PLUS 2 years of experience in a health care or managed care setting required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
• Have access to means of transportation for work away from the primary office approximately 5% of the time.Preferred Qualifications :
• 2 years of experience in invoice reconciliation and medical billing / coding required, preferably for Medicaid / Medi-Cal.
• 2 years of experience of data entry completion.
• Experience working with the needs of seniors or persons with disabilities (SPD) in a customer / member service capacity.
• Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Spanish, Vietnamese).Required Licensure / Certifications :
• n / aKnowledge & Abilities :
• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees / coalitions.
• Utilize computer and appropriate software (e.g., Microsoft Office : Word, Outlook, Excel, PowerPoint) and job specific applications / systems to produce correspondence, charts, spreadsheets, and / or other information applicable to the position assignment.Physical Requirements (With or Without Accommodations) :
• Ability to visually read information from computer screens, forms and other printed materials and information.
• Ability to speak (enunciate) clearly in conversation and general communication.
• Hearing ability for verbal communication / conversation / responses via telephone, telephone systems, and face-to-face interactions.
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
• Lifting and moving objects, patients and / or equipment 10 to 25 poundsWork Environment : If located at the 500, 505 Building or a remote work location :
• Work is typically indoors and sedentary and is subject to schedule changes and / or variable work hours, with travel as needed.
• There are no harmful environmental conditions present for this job.
• The noise level in this work environment is usually moderate.If located at PACE :
• Work is typically indoors in a clinical setting serving the frail and elderly.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.If located in the Community :
• Work is typically indoors and sedentary and is subject to schedule changes and / or variable work hours, with travel as needed.
• Employee will occasionally work outdoors in varied temperatures.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.

Client Details

Address505 City Parkway WestCityOrangeStateCAZip Code92868

Salary : $1,100