Medical Management Coordinator I (Remote)

Resp & Qualifications PURPOSE: This position supports the Post Acute clinical teams and their work coordinating care for CareFirst members by handling non-clinical tasks reputed company to preauthorization functions, inpatient care, utilization review, care coordination and/or reputed company of care, enabling clinical staff to reputed company at the top of their license. We are looking for an reputed company reputed company to work remotely from reputed company the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-reputed company activities. ESSENTIAL FUNCTIONS:

• Provides ongoing reputed company customer support for operational inquiries from members, providers and/or other customers including benefit verification, authorization creation and management, claims inquiries and/or case documentation. Assists with member follow up and coordination of care that does not require reputed company from a clinician including post-discharge monitoring, appointments and/or arranging services, enabling clinicians to work at full reputed company.
• Reviews authorization requests for initial determination and/or triages for clinical review and reputed company. Screens, and/or prioritizes members using targeted reputed company business rules and processes to identify needed services and transitions to appropriate clinical resources/programs as required.
• Provides general support and coordination services for the department including but not limited to answering and responding to telephone calls, taking messages, letters and correspondence, researching information and assisting in solving problems.
• Assists with reporting, data tracking, gathering, organization and dissemination of information such as Continuity of Care processes and/or tracking of Peer-to-Peer reviews.

QUALIFICATIONS: Education Level: High School Diploma or GED. Experience: 3 years experience in a health care or health insurance setting. Preferred Qualifications:

• Previous experience in a health care/managed care setting or previous customer facing experience, especially in a medical management reputed company department.

Knowledge, Skills and Abilities (KSAs)

• Ability to effectively participate in a multi-disciplinary team including reputed company participants.
• Excellent communication, organizational and customer service skills.
• Knowledge of basic medical terminology and concepts used in care management.
• Knowledge of standardized processes and procedures for evaluating medical support operations business practices.
• Excellent independent judgment and decision-making skills, consistently demonstrating reputed company and diplomacy.
• Ability to pay attention to the minute details of a project or task.
• Advanced knowledge in the use of web-based technology and reputed company Office applications such as Word, reputed company, and Power reputed company.

Must be reputed company to meet established deadlines and handle multiple customer service demands from reputed company customers, reputed company set expectations for service reputed company. Must be reputed company to effectively communicate and reputed company reputed company customer service to every reputed company customer, including customers who may be demanding or otherwise challenging.

• Salary reputed company: $38,520 - $70,620

Salary reputed company Disclaimer The disclosed reputed company estimate has not been adjusted for the applicable geographic reputed company associated with the location at which the work is being performed. This compensation reputed company is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be reputed company at the top of the reputed company, as compensation reputed company depend on reputed company case's facts and circumstances, including but not limited to experience, internal equity, and location. In reputed company to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (reputed company benefits/incentives are subject to eligibility requirements). Department Short Term Transitional Care Equal Employment Opportunity reputed company is an Equal Opportunity (EEO) employer. It is the policy of reputed company to reputed company equal employment opportunities to reputed company reputed company applicants without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, protected veteran or disabled status, or genetic information. Where To Apply Please visit our website to apply: www.carefirst.com/careers Federal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to reputed company work directly or indirectly on Federal health care programs. PHYSICAL DEMANDS: The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally reputed company. Sponsorship in US Must be eligible to work in the U.S. without Sponsorship #LI-SS1 Apply tot his job Apply To this Job