Overview
Medical Management – Support Specialist Jobs in Remote at Imagine360
Full Job Description
Imagine360 is currently seeking a Medical Management Support Specialist to join our team!This The Medical Management Support Specialist will assist the Medical Management Clinicians by supporting non-clinical tasks and/or projects as assigned.
Position: 100% Remote
Responsibilities include but are not limited to:
Assist Medical Management Supervisor, Managers, and Clinicians with non-clinical tasks as instructed by the direct supervisor.
Assigns cases to the appropriate clinical employee, following approved criteria for case assignment; will also transfer non-clinical data as well as structure clinical data, as directed by clinical and non-clinical supervisor(s).
Communicates professionally with external providers and vendors to assist with case documentation, requesting clinical documents for clinical staff review.
Following a script, completes non-clinical outreach calls to clients to gather information related to program enrollment, as instructed by Supervisor.
Assists with Stop Loss communication by sending Stop Loss letters to the Stop Loss Carriers as instructed.
Monitor specific department email inboxes and assign cases to clinical employees and direct communications received to the appropriate employee as instructed by Supervisor.
Pull program satisfaction survey results and distribute to appropriate employees as needed.
Run and assemble internal and external reports as instructed.
Maintain inventory of education and resources for the team.
Mail letters and education material for Medical Management programs to members.
Process returned mail for Medical Management.
Prepare & maintain new hire binders as needed.
Help organize and attend scheduled meetings and trainings for the department or company via teleconference or in person.
Process participant assessments as assigned.
Work collaboratively within a team setting to provide positive outcomes for members, clients, peers, and overall operations.
Performs all tasks in accordance with Medical Management policies and procedures and HIPAA/PHI guidelines and follows the policies and procedures as it relates to escalating issues within the staff hierarchy and between clinical and non-clinical staff.
Completes all tasks on time and with accuracy.
Participate in quality program as assigned.
Perform all tasks in accordance with HIPAA/PHI guidelines.
Complete HIPAA training annually.
Perform other duties as assigned.
Required Education and Experience:
0-1 + years’ experience working in an administrative support role.
Experience working with Microsoft Office including Word, Excel, and PowerPoint.
Experience navigating the internet and using database software.
Preferred Experience
Prior experience working in an administrative support role specifically supporting non-clinical healthcare operations preferred.
What can Imagine360 offer you?
Multiple Health Plan Options, including a 100% employee paid premiums
100% Company paid employee premiums for Dental, Vision, STA, & LTD, plus Life Insurance
Parental Leave Policy
20 days PTO to start / 10 Paid Holidays
Tuition reimbursement
401k Company contribution
Professional development initiatives / continuous learning opportunities
Opportunities to participate in and support the company’s diversity and inclusion initiatives
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Imagine360 is a health plan solution company that combines 5…
Title: Medical Management – Support Specialist
Company: Imagine360
Location: Remote
Category:
