Bilingual- Medical Authorization Assistant at Ultimate Staffing Services in Orange, California

Job Description:

Now Hiring: Medical Authorization Assistant (6-Month Contract)


We're seeking a dedicated and organized individual to join our team as a Medical Authorization Assistant for a 6-month contract. In this role, you'll provide vital office and case management support by acting as a liaison between members, physicians, nursing home facilities, community organizations, and providers. Responsibilities include handling initial information intake, assisting with authorization tasks, and gathering essential data, all while ensuring effective and courteous communication in every interaction. This role will be performed under the guidance of licensed Medical Case Managers, Social Workers, Program Managers, and department managers. If you're ready to contribute to healthcare excellence on a temporary basis, we'd love to hear from you!


Schedule: M-F 8AM-5PM
Pay rate: $23.92-33.48


Responsibilities


Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.


Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.


Receives cases via mail, fax, phone or electronically and enters data for new case information into the medical management systems.


Conducts individual interviews with members and/or providers to obtain intake information and gather data.


Works with the Medical Case Manager to authorize requested services according to department guidelines and verifies eligibility through the state systems.


Contacts the health networks and/or Customer Service department regarding health network enrollments, changes in address and primary care provider.


Assists in gathering medical records, obtaining appropriate coding for diagnosis and procedures and follows up on phone calls.


Documents all contacts and case information in the appropriate medical management system using the standard charting format.


Performs data entry into the appropriate databases for monitoring and tracking, trending of cases and other relevant databases as needed.


Generates monthly and other required reports from the databases as requested by the Medical Case Manager and/or health networks.


Sends letters to providers and members.


Answers calls and provides customer service to providers and members, provides care coordination and refers the callers to the correct department.


Completes other projects and duties as assigned.


Possesses the Ability To:


Utilize prior authorization protocols to determine when to refer matters to a licensed staff member.


Obtain relevant data needed from members, providers, etc. and record and summarize findings.


Establish and maintain effective working relationships with leadership, staff, community agencies, providers and members.


Communicate clearly and concisely, both orally and in writing with individuals from varying cultural and ethnic backgrounds.


Utilize computer and appropriate software (e.g., Microsoft Office: Excel, Outlook, PowerPoint, Word) and job-specific applications/systems to produce correspondence, charts, spreadsheets and/or other information applicable to the position assignment.


Experience & Education


High School diploma or equivalent required.


2 years of experience in a health care or managed care setting required.


An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.


Preferred Qualifications


Certified Medical Assistant (CMA) certification.


Experience working with the needs of seniors or persons with disabilities (SPD) in a customer/member service capacity.


Previous medical billing or coding experience.


Utilization management experience.


Bilingual in English and in one of defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese).


All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. For unincorporated Los Angeles county , to the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.