What are the responsibilities and job description for the Medical Assistant (Utilization Management) position at Cross Country Workforce Solutions Group?
Job Summary:
This position is responsible for providing support to the Medical Management department to ensure timeliness of outpatient or inpatient referral/authorization
processing per state and federal guidelines. This position performs troubleshooting when problems situations arise and coordinates with leadership.
Skills and Abilities:
1. Knowledge of medical terminology and coding (e.g., ICD-10, CPT, HCPCS).
2. Knowledge of the health care industry, preferably managed care.
3. Knowledge of computer skills in word processing, authorization systems and spreadsheets.
4. Ability to type a min. of 30 words per minute.
5. Knowledge of HIPAA Guidelines including the PHI privacy requirements.
6. Exceptional organizational skills.
7. Bilingual English/Spanish preferred.
Education and Experience:
1. High School Diploma or equivalent required.
2. MA or Medical Billing Certificate preferred.
3. Minimum 1 year of experience working in a medical billing environment (IPA or HMO preferred), with pre-authorizations and reimbursement
regulations pertaining to Medi-Cal, CCS and other government programs required.
4. Prior experience working in a clinic/health care specialty call center.
5. Prefer experience in utilization management processing authorization referrals.
Salary : $23 - $26
