Medical Management Assistant

Supporting the Medical Management department, the full-time Medical Management Assistant will manage provider communications, enter data into the case management system, and assist clinical staff in ensuring quality care for members while working remotely from 8 am to 5 pm Pacific Time, Monday through Friday. Key responsibilities Process claims for inpatient and outpatient services by entering data and triaging events according to departmental guidelines Verify member data and assist in maintaining eligibility and program participation information Provide professional customer service to internal and external customers while maintaining confidentiality and adhering to compliance standards Required 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 and knowledge of medical terminology required Utilization Management experience is required Working knowledge of Medicare and Medi-Cal guidelines preferred