Medical assistant

Medical Authorization Assistant Senior Services Program

Company Overview : Our client, a leading healthcare provider based in Orange, CA, is seeking a dedicated Medical Authorization Assistant, who will provide office and case management support services.

Position Summary : We are looking for a qualified candidate with at least 2 years of experience in medical billing / coding, data entry and invoice reconciliation.

Work duration : Up to 6 months

Job type : On-site

Position Responsibilities

• Receives cases via fax, phone or electronically and enters new case information into the MSSPCare Online and Jiva systems.
• Conducts individual interviews / assessments with members and providers to obtain intake information.
• Obtains information on requested services according to department guidelines, performs data entry into MSSPCare Online and Jiva and verifies eligibility
• Contacts the health networks and Customer Service regarding health network enrollments.
• Assists the Medical Case Managers and Social Workers in gathering medical records, obtaining appropriate information on diagnoses and procedures and following up on phone calls.
• Documents all contacts and case information in the appropriate MSSPCare Online and Jiva scripts or activity as appropriate.
• Assists 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.
• Performs 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.
• Generates monthly and other required reports from the databases as requested by the Medical Case Managers, Social Workers and / or health networks.
• Provides customer service to providers and members. Purchases, delivers and / or retrieves items from vendors and / or MSSP participants as requested by the Medical Case Managers or Social Workers.
• Conducts in-home visits to retrieve signatures on care plans or other documents.

Minimum Qualifications

• High School diploma or equivalent
• 2 years of experience in invoice reconciliation and medical billing / coding required, preferably for Medicaid / Medi-Cal.
• 2 years of experience of data entry
• Experience working with the needs of seniors or persons with disabilities (SPD) in a customer / member service capacity
• Have access to means of transportation for work away from the primary office approximately 5% of the time.
• Bilingual in English and in one of the following languages preferred : Arabic, Farsi, Chinese, Korean, Spanish, or Vietnamese.

Possesses the Ability To :

• Develop rapport and establish and maintain effective working relationships with 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 : Excel, Outlook, PowerPoint, Word) and job-specific applications / systems.

Sunshine Enterprise USA is an Equal Opportunity Employer Minorities, Females, Veterans and Disabled Persons

PI255455301

Last updated : 2024-11-26