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Medical Coordinator

Elite TechnicalBaltimore, MD🇺🇸United States

Quick overview

SeniorityMid Senior
Work modeOn Site
LocationBaltimore, MD, United States
ICD-10Triage

Job description

Medical Coordinator

Elite Technical is seeking a Medical Management Coordinator (MMC) in the Maryland/Washington DC area for a hybrid opportunity with our client, working three days per week onsite.

Responsibilities

The role of the MMC is to assist with:

  • Triage and enter appeals with accuracy and urgency
  • Process medical records requests and prepare overturn notices
  • Build shell cases in GuidingCare and draft appeal letters
  • Route final decisions and generate/mail letters and FFRNs
  • Monitor the adjustment queue to keep cases moving
  • Notify providers the same day decisions are made, ensuring communication is fast and reliable

Requirements

<>Required Skills:
  • High School Diploma
  • Minimum 2 years of experience in a healthcare/managed care setting or previous work experience within the division
  • Knowledge of CPT and ICD-10 coding
  • Experience with previous appeals, ability to review letters of appeal, and identify claims
  • Experience with Healthedge GuidingCare
  • Experience with Facets (Legacy and/or G6)
<>Preferred Skills:
  • NASCO experience is a plus
  • Lotus Notes (now HCL Notes) experience is a plus

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