Medical Assistant, Utilization Management

📋 Description

• Review consults, imaging, and procedure summaries to determine follow-up needs.
• Enter orders for PCPs based on provider direction and summaries.
• Manage clinical inboxes, emails, and fax queues for docs and requests.
• Coordinate with UM staff to route documents across systems.
• Identify and correct inconsistencies in orders with UM authorizations.
• Collaborate with providers to resolve authorization and order gaps.
• Meet operational performance targets as defined by data and reporting.

🎯 Requirements

• Current MA Certificate; home health/clinical experience preferred.
• 2-year MA program accredited by CAAHEP or ABHES.
• Certification by a MA certifying organization approved by the State Medical Board, preferred.
• 1 year chart auditing or UM review; 2+ years admin and clinical work.
• Experience with Athena EHR, preferred.
• Knowledge of Medicare and Medicaid UM regulations.

🎁 Benefits

• Standard business hours
• Full medical, dental, and vision coverage
• PTO: 17 days, 12 holidays, 6 sick days
• Additional benefits