Medical Management Assistant (SCAN Temp)

SCAN Health Plan • Long Beach, CA

5d • Remote

About The Position

The Medical Management Assistant supports SCAN’s Medical Management department by responding to provider calls and faxes, entering inpatient and related information into the case management system (CCMS), authorizing SCAN services under clinical staff direction, and helping clinical staff secure information needed to deliver quality care and services to members. This is a temporary remote role expected to last approximately 3–6 months, with a Monday–Friday schedule from 8:00 a.m. to 5:00 p.m. Pacific Time.

The role supports authorization, monitoring, and claims processing for inpatient and outpatient services, verifies member and provider information, and responds to internal and external customers. The assistant follows departmental workflows and procedures, maintains confidentiality, communicates professionally with members and providers, identifies barriers for supervisory attention, and adheres to quality, compliance, and regulatory standards. The position also contributes to team goals and supports SCAN’s vision and goals.

Requirements

• High school diploma or equivalent required.
• Proficiency with data entry required.
• Knowledge of medical terminology required.
• Utilization Management experience required.
• Excellent communication skills, primarily by telephone.
• Strong organizational skills and ability to prioritize.
• Ability to multitask and work with limited supervision.
• Ability to work well in a fast-paced and dynamic environment.
• Ability to provide professional customer service.
• Proficiency in MS Office.
• Background check required.

Nice To Haves

• Associate’s degree or equivalent experience preferred.
• At least 3 years of medical experience in a managed care environment preferred.
• ICD-9 and CPT coding experience preferred.
• Working knowledge of Medicare and Medi-Cal guidelines preferred.

Responsibilities

• Support authorization, monitoring, and claims processing for inpatient and outpatient services by entering data into designated systems and triaging events according to department guidelines.
• Maintain data-entry requirements by following established workflows and departmental policies and procedures.
• Verify member eligibility, participation in SCAN Care Management Programs, benefits, network provider status, contracts, and division of financial responsibility (DOFR).
• Answer telephone calls within established turnaround times.
• Serve as a resource for internal and external customers, ensuring services align with benefit plans and use contracted providers, while developing collaborative relationships with network providers.
• Interact with providers in an appropriate, timely, and professional manner and promptly report problems or issues.
• Maintain member privacy and protect confidential information.
• Use department desktop procedures, workflows, job aids, and training materials.
• Identify barriers and bring them to the attention of a supervisor or manager.
• Communicate appropriate and timely information to members, caregivers, and representatives with courtesy and respect.
• Adhere to quality, compliance, and regulatory standards to achieve HCS and SCAN outcomes.
• Contribute to team efforts and accomplish related tasks as needed.
• Actively support SCAN’s vision and goals.
• Perform other duties as assigned.

Benefits

• Annual employee bonus program.
• Robust wellness program.
• Generous paid time off (PTO).
• Eleven paid holidays per year, plus one floating holiday and one birthday holiday.
• 401(k) retirement savings plan with employer match.
• Employee recognition program.
• Tuition reimbursement.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED