Utilization Management Medical Assistant

📋 Description

• Review consults, imaging, and procedures to determine follow-up needs.
• Enter orders for PCPs based on provider directions and external summaries.
• Manage clinical inboxes and fax queues for documents and authorizations.
• Collaborate with UM Coordinators, Nurses, Medical Records, and staff for routing.
• Identify and correct inconsistencies in UM authorizations.
• Collaborate to resolve authorization and order gaps.
• Meet operational performance metrics per data reporting.

🎯 Requirements

• Current MA certificate; home health/clinical experience preferred.
• 2-year MA degree accredited by CAAHEP or ABHES.
• Certification by an approved MA certifying organization (preferred).
• Minimum 1 year chart auditing/UM review; 2 years admin/clinical work.
• Experience with Athena EHR (preferred).
• Knowledge of Medicare and Medicaid UM regulations.

🎁 Benefits

• Standard business working hours.
• Full medical, dental, and vision insurance starting day one.
• PTO, holidays, and sick days: 17 PTO days, 12 holidays, 6 sick days.
• And additional benefits.