Heathcare/ Medical Management Coordinator
nTech Workforce
Job Description
Title: Medical Management Coordinator
\nLocation: Baltimore, MD 21224 (Hybrid)
\nDuration: 6 Months Contract
\n \nJob Description:
\n- \n
- Terms of Employment \n
- W2 Contract, 6 Months \n
- Hybrid: 1–2 days on-site per week; regular weekly in-office presence required) \n
- Work Hours: Full-time, 40 hours/week (Core hours: 8:00 AM – 5:00 PM) \n
- \n
- Overview \n
- Client is seeking detail-oriented Medical Management Coordinators to join a leading healthcare organization’s Clinical Appeals and Analysis Unit (CAU) in Canton. This role provides non-clinical operational and administrative support to streamline clinical appeals, case processing, and documentation. Working alongside a dedicated team of clinical analysts and nurses, you will play a crucial role in managing case entries, generating overturn notices, processing medical records requests, and managing physical mailings. \n
- \n
- Key Responsibilities \n
- Prepare, manually print, and package full-on fair appeal cases and letters for shipment through the on-site mailroom via FedEx. \n
- Assist with creating shell cases and entering case details into internal systems based on unit needs. \n
- Review and determine if medical records are required for specific appeal cases and facilitate request fulfillment. \n
- Draft, review, and print standardized overturn notices and related case documentation. \n
- Perform initial triaging of incoming documentation to verify appropriateness for clinical appeals processing. \n
- Utilize core healthcare administration platforms (GuidingCare and Facets) to navigate patient and claim details. \n
- Collaborate with clinical analysts and supervisor team members to maintain workflow efficiency during core business hours. \n
- \n
- Required Skills & Experience \n
- 2+ years of administrative or operational experience within a healthcare, managed care, or health insurance environment. \n
- Demonstrated experience navigating healthcare system platforms, specifically GuidingCare (Legacy or G6) and Facets. \n
- Familiarity with healthcare claims, clinical appeals, or Utilization Management (UM) processes. \n
- Practical knowledge or exposure to medical coding conventions, including CPT and ICD (ICD-9 / ICD-10) terminology. \n
- Local residency near the Canton location with full availability to work on-site 1–2 days per week as scheduled. \n
- \n
- Preferred Skills & Experience \n
- Previous experience in a medical billing, claims processing, or provider office setting. \n
- Familiarity with NASCO, Lotus Notes, or Explanation of Benefits (EOB) lookup systems. \n
- Prior experience handling confidential medical records, overturn notices, or legal appeal document packaging. \n
Sincerely,Preetam Raj
\nLead Technical Recruiter
\nnTech Workforce Inc.
\nD: View phone number on ziprecruiter.com
\nE: View email address on ziprecruiter.com
\npreetam(at)ntechworkforce(dot)com
Vacancy posted 3 days ago
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