Heathcare/ Medical Management Coordinator
Full-time
nTech Workforce
Title: Medical Management Coordinator
Location: Baltimore, MD 21224 (Hybrid)
Duration: 6 Months Contract
Job Description:
- Terms of Employment
- W2 Contract, 6 Months
- Hybrid: 1–2 days on-site per week; regular weekly in-office presence required)
- Work Hours: Full-time, 40 hours/week (Core hours: 8:00 AM – 5:00 PM)
- Overview
- 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.
- Key Responsibilities
- Prepare, manually print, and package full-on fair appeal cases and letters for shipment through the on-site mailroom via FedEx.
- Assist with creating shell cases and entering case details into internal systems based on unit needs.
- Review and determine if medical records are required for specific appeal cases and facilitate request fulfillment.
- Draft, review, and print standardized overturn notices and related case documentation.
- Perform initial triaging of incoming documentation to verify appropriateness for clinical appeals processing.
- Utilize core healthcare administration platforms (GuidingCare and Facets) to navigate patient and claim details.
- Collaborate with clinical analysts and supervisor team members to maintain workflow efficiency during core business hours.
- Required Skills & Experience
- 2+ years of administrative or operational experience within a healthcare, managed care, or health insurance environment.
- Demonstrated experience navigating healthcare system platforms, specifically GuidingCare (Legacy or G6) and Facets.
- Familiarity with healthcare claims, clinical appeals, or Utilization Management (UM) processes.
- Practical knowledge or exposure to medical coding conventions, including CPT and ICD (ICD-9 / ICD-10) terminology.
- Local residency near the Canton location with full availability to work on-site 1–2 days per week as scheduled.
- Preferred Skills & Experience
- Previous experience in a medical billing, claims processing, or provider office setting.
- Familiarity with NASCO, Lotus Notes, or Explanation of Benefits (EOB) lookup systems.
- Prior experience handling confidential medical records, overturn notices, or legal appeal document packaging.
Sincerely,Preetam Raj
Lead Technical Recruiter
nTech Workforce Inc.
D: View phone number on click.appcast.io
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preetam(at)ntechworkforce(dot)com
Vacancy posted 1 day ago
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