Medical Assistant, Utilization Management

📋 Description

• Conduct review of consult summaries, imaging results, procedure summaries, and more, to determine
• Enter orders on behalf of PCP or ordering provider, based on PCP direction and consult summaries
• Manage departmental clinical inboxes, email inboxes, and fax queues to ensure appropriate handling
• Work closely with UM Coordinators, UM Nurses, Medical Records, Provider Networking, and
• Identify, document, and correct inconsistencies and gaps in participants’ orders with
• Collaborate with providers, clinical staff, and others to resolve any authorization and order gaps

🎯 Requirements

• Current MA Certificate; MA experience in a home health/clinical setting preferred
• 2-year degree program in Medical Assistance Accredited by the Commission on Accreditation of Allied
• Certification by a Medical Assistant Certifying Organization approved by the State Medical Board
• Minimum of one (1) year of chart auditing or UM review experience, and a minimum of two (2) years
• Experience working in Athena Electronic Health Record, preferred
• Knowledge in Medicare and Medicaid UM regulations

🎁 Benefits

• Standard business working hours
• Full medical, dental, and vision insurance
• Work/life balance - we mean it! 17 days of personal time off (PTO), 12 holidays observed annually
• And additional benefits