Medical Assistant V-Fully Remote-Managed Care Healthcare

Medical Assistant V-Large Managed Care Company

Fully Remote...

6-month contract with potential for permanent hire

Starting at $40 an hour plus insurance

Hours:The training schedule will be M-F 8AM-4PM EST. After training schedule will be M-F 9AM-5PM local time, there is flexibility in schedules that can be discussed further.
No specific work location 100% however must be available to train in EASTERN STANDARD TIME.
Possible OT at the end of the quarters.
Potential to convert to an FTE with a positive work record.

Job Description: This position works under the supervision of the Medical Claims Review Nurse and is cross-trained to work in a variety of areas and functions, including appeals, claims analytics, DRG Validation claims repricing, and outpatient payment integrity audit concepts. Day to Day Responsibilities:

•Completing non-clinical appeals reviews for overpaid claims.
•Complete repricing of identified claims to identify overpayment variances for DRG Validation claims.
•Completing outpatient payment integrity audits

Must Have Knowledge:
•Knowledge of all back office functions of a medical assistant in accordance with the MA scope of practice and protocol.
•These functions include but are not limited to: intake and recording of health and immunization history, patient preparation for exam or procedure, administration of screening (hearing/vision) tests, preparation, administration of immunizations/medication, processing vital signs, venipuncture/blood draw/phlebotomy, and administration of injections.
•Able to provide guidance to the staff and feedback to management on the performance of audit concepts performance.
•Proficient in State and Federal Regulatory programs and their required documentation processes required for claim payment. Assures completion of patient visit documentation including logs, patient charting, inventory, etc. by provider & staff on date of patient visit.
Must Have Skills:

•Proficient in medical terminology.
•Good interpersonal and problem solving skills.
•Must have the ability to satisfactorily speak, read, write and understand English for effective communication.
•Must be computer proficient in typing and system/ database support.
•Knowledge of Electronic Medical Record (EMR) and Practice Management (PM) systems are a plus.
•Maintain regular attendance based on agreed-upon schedule.
•Maintain confidentiality and comply with all Health Insurance Portability and Accountability Act (HIPAA) and Protected Health Information (PHI) Regulations. •Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.

Required Years of Experience: 5+ years Medical Assistant Experience
Required Licensure / Education: High School Diploma or GED equivalent.
Medical Assistant program graduate from a federally accredited, State licensed vocational/technical school.

Job Types: Full-time, Contract

Pay: From $40.00 per hour

Expected hours: 40 per week

Benefits:
• 401(k)
• Health insurance

Schedule:
• Monday to Friday

Experience:
• Medical Assistant: 5 years (Required)
• Appeal Reviews and Pricing Audit: 3 years (Required)

License/Certification:
• Federally Accredited Certified Medical Assistant (Required)

Work Location: Remote

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