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Job Field: Office Jobs
Location: PORTLAND, WA
Salary: $-
Job Type: Part Time

JOB SUMMARY:

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               <td align="left"><font style="font-size: 100%;">Title: Medical Management Coordinator MA<BR>Location: Oregon-Portland<BR>Job Number:_19019<BR>Providence is calling a full-time Medical Management Coordinator for a day shift position at Providence Office Park in Portland, OR. <BR><BR>In this position, you will:<BR><BR><BR>* Be responsible for the implementation of policies and procedures relating to aspects of the Medical Management Program and Work plan of Providence Physicians Division (PPD).<BR>* Perform duties supporting the core functional areas of: specialist referral processing, prior authorization, diagnostic imaging scheduling, physician call triaging, appeals, auditing and training.<BR>* Focus on the technical support and the organization/coordination of support activities such as: production, program outcomes against stated policies, standards and objectives; and the development of training and documentation for process and performance improvement activities relevant to the Medical Management Program.<BR>* Assure an integrated approach to the program is fulfilled, resulting in timely scheduling of requested services, communication across the continuum of care for requested outpatient services resulting in improvement in the provision of care and services and improved satisfaction for our patients, providers, staff and external contacts.<BR>* Function in a team environment, providing requested services in a centralized setting on behalf of the PPD clinics.<BR>* Serve as an expert resource to PPD providers, specialists and staff in regard to the specialist referral / prior authorization requirements for multiple contracted and non-contracted insurance plans, diagnostic imaging protocols which vary between the multiple facilities/sites providing this service, and processes relating to these functions.<BR>* Be the liaison between PPD physicians, patients, multiple Providence Health System Diagnostic Imaging scheduling and modality (e.g., CT, MRI, Nuclear Medicine) departments, freestanding diagnostic imaging centers and the contracted insurance plans. In addition to specialist referral processing, this position also facilitates prior-authorization for selected procedures as directed by the patients? insurance.<BR><BR>Qualifications:<BR><BR><BR>Required qualifications for this position include:<BR><BR>* High school diploma or equivalent.<BR>* Current state registration, license, or certification as appropriate to education.<BR>* Knowledge of coding, medical terminology, insurance billing, claims and managed care principles.<BR>* Excellent verbal communication, negotiation and interpersonal skills.<BR><BR><BR><BR><BR>Preferred qualifications for this position include:<BR><BR>* Undergraduate degree preferred or equivalent work experience in a medical clinic or managed care/health insurance plan (3-5 years in a related field).<BR>* CMA or MA with clinical experience working in clinic setting.<BR>* Two additional years in a business environment preferred.<BR>* Working knowledge and/or experience in a utilization management functional area such as prior authorization, medical audit, appeals or                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       </font></td>
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