Medical Management Assistant (SCAN Temp)

SCAN Health Insurance • Long Beach, CA

6d • $20 - $28 • 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 data into the case management system (CCMS), authorizing SCAN services under the direction of clinical staff, and helping clinical staff obtain information needed to ensure quality care and services for SCAN members. This is a temporary remote role of 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 eligibility, program participation, benefits, provider network status, contracts, and financial responsibility; and provides professional, timely service to members, providers, and internal customers. The assistant follows established workflows, policies, desktop procedures, and regulatory requirements, maintains confidentiality, and escalates barriers or problems to a supervisor or manager.

SCAN is a nonprofit health organization focused on improving care for older adults. It serves more than 500,000 people across several states and offers care through Medicare Advantage, integrated care, primary care, and other care delivery models.

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 effectively in a fast-paced and dynamic environment.
• Ability to provide professional customer service.
• Proficiency in MS Office.

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.
• Curiosity about AI and its potential to transform operations and member service.

Responsibilities

• Support authorization, monitoring, and processing of claims for inpatient and outpatient services by entering data into designated systems and triaging events according to department guidelines.
• Follow established workflows and departmental policies and procedures to maintain data-entry requirements.
• Verify member eligibility, participation in SCAN Care Management Programs, benefits, network provider status, contracts, and division of financial responsibility.
• Answer calls within established turnaround times and maintain telephone standards.
• Serve as a resource for internal and external customers by ensuring services align with benefit plans and use contracted providers; develop collaborative partnerships with network providers.
• Interact with providers professionally and in a timely manner, and promptly report problems or issues.
• Maintain member privacy and keep confidential information protected.
• Use department desktop procedures, workflows, job aids, and training materials; identify barriers and bring them to a supervisor or manager.
• Communicate appropriately and promptly with members, caregivers, and representatives, showing courtesy and respect.
• Adhere to quality, compliance, and regulatory standards to achieve HCS and SCAN outcomes.
• Contribute to team efforts by completing related tasks as needed.
• Support SCAN’s vision and goals and 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
• Education Level: High school or GED