Summary: National Managed Care Organization is a great place to work because we are committed to providing high-quality healthcare services and improving the lives of our members. We value our employees’ contributions and offer opportunities for growth and development. Join our team and make a difference in the healthcare industry!
Job Description:
Position: Medical Assistant IV (Temp-to-Perm)
Pay: $36.00 per hour (You must have DRG Claims experience)
Location: Fully Remote – Must live in Eastern Time Zone
Schedule: Monday-Friday, 9AM-5PM (local time) Training Schedule: Monday-Friday, 9AM-5PM (EST)
Job Description: As a Medical Assistant IV at National Managed Care Organization, you will work under the supervision of the Medical Claims Review Nurse and receive cross-training to perform various tasks in different areas, including appeals, claims analytics, DRG Validation claims repricing, and outpatient payment integrity audit concepts.
Daily Responsibilities:
Conduct non-clinical appeals reviews for overpaid claims.
Perform repricing of identified claims to identify overpayment variances for DRG Validation claims.
Demonstrate proficiency in State and Federal Regulatory programs and their required documentation processes necessary for claim payment.
Ensure completion of patient visit documentation, including logs, patient charting, inventory, etc., by the provider and staff on the date of the patient visit.
Qualifications:
Knowledge of all back office functions of a medical assistant in accordance with the MA scope of practice and protocol.
Required Education: High School Diploma or GED equivalent.
Required Experience: Minimum of 5 years of Medical Assistant experience.
Required Licensure/Certification: Graduate of a Medical Assistant program from a federally accredited, State-licensed vocational/technical school.
National Managed Care Organization is an equal opportunity employer and encourages a diverse and inclusive workforce. We are committed to providing our employees with opportunities for career advancement and professional development. Join our team and be a part of our mission to improve healthcare outcomes for our members.
Morgan Stephens
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