WI3669328

1

High School Diploma/GED

High School Diploma/GED Equivalent

Unspecified

40

JOB REQUIREMENTS: Medical Management Assistant Job Locations
US-WI-Madison ID 2024-2081 Category Clinical Services Type Regular
Full-Time Overview Quartz is seeking detail oriented, well organized
individual to support our Utilization Management team as a Medical
Management Assistant. This role will work with in the NCQA requirements
for completion and turn-around times for requests and cases and assists
with adherence to processes, making determinations based on
policies/procedures in effect within the department and referring the
next level of review when appropriate. This position will also provide
detailed customer service to patients, providers and clinic staff
regarding pre-service, concurrent and post-service requests with
documentation in appropriate systems or databases. Benefits: Full-time,
remote work environment available Work schedule an 8-hour schedule
between the hours of 8:00am - 5:00pm, Monday - Friday Starting pay
range: \$20hr. Responsibilities Provides appropriate notification to
nursing staff of all requests and hospitalizations requiring further
review. Makes approval determinations according to written protocols and
guidelines as appropriate. Refers any medical questions or potential
denial determinations to nursing staff for further review. Assists in
the medical review process for referrals, prior authorizations,
inpatient reviews and claims reviews by obtaining appropriate supporting
information and documentation to assist in making necessity and benefit
determinations as well as reconsiderations. Provides telephone customer
service for members, providers, and other Health System or Quartz staff
regarding authorization requests, hospitalizations and claim questions.
Qualifications High school diploma or equivalent 1+ year of experience
working in a healthcare environment, such as claims processing, medical
billing/insurance claims, or related experience Experience with computer
applications such as MS Office and/or Epic Prior data entry and word
processing experience is preferred Great attention to detail and
excellent organizational skills Excellent oral and written communication
skills, including phone skills Knowledge of medical terminology;
previous experience in a medical office or medical field is preferred
General knowledge of NCQA requirements is preferred Bilingual applicants
encouraged to apply! This full-time position will have the option to
work in-person from our Madison, WI or Onalaska, WI office, in a hybrid
capacity, or as a telecommuter. Hardware and equipment will be provided
by the company, but candidates must have access to high-speed internet
to successfully work from home. Quartz offers competitive compensation,
an excellent benefit package and a professional culture built on the
foundations of Respect,\... For full info follow application link. Equal
Opportunity Employer of Minorities, Females, Protected Veterans, and
Individual with Disabilities \*\*\*\*\* APPLICATION INSTRUCTIONS: Apply
Online: ipc.us/t/3866077CE1D040A4