Medical Management Assistant

The Medical Management Assistant position reports directly to the Lead Medical Management Nurse/Supervisor. The Administrative Support staff provides a wide range of administrative tasks and clerical support to the professional Nursing staff, with the primary focus on the intake process regarding new referrals, including scanning, uploading, indexing documents into the managed care database and assigning case management referrals to registered nursing staff.  

ESSENTIAL DUTIES AND RESPONSIBILITIES:

To perform this job successfully, the employee must be able to efficiently and effectively perform each of the following essential functions.  Reasonable accommodation may be made for individuals with disabilities.

The functions of this job include but are not limited to:

• Intake, prioritizing and timely processing of new Case Management referrals.
• Collects, processes and distributes faxes accordingly. 
• Contacts Claims Examiner to clarify unclear referrals.
• Ensures the privacy and security of Protected Health Information (PHI).
• Enters/uploads/indexes reports and documents clear notes into the CM Software Application System.
• Assigns Case Manager tasks to clinical staff in a timely manner. 
• Makes timely, pertinent phone calls to obtain medical reports, treatment plan and RTW related information/reports to provide to the Case Management Registered Nursing staff.
• Transfers any/all calls where there is clinical information being provided (or a clinically related question surfaces) to a registered nurse for response.
• Schedules Injured Worker appointments, as appropriate and under the direction of clinical staff.
• Types injured worker appointment letters and other pertinent letters as requested by and under the oversight of a registered nurse.
• Maintains ongoing non-clinical communications, collaborates with pertinent parties related to claims that are open to an active treatment request and/or to Case Management. 
• Performs a broad range of administrative and clerical duties, including the transcribing of medical report information (without analyzing or interpreting clinical information), inputting information obtained from telephone calls and various correspondence.
• Keeps applicable data and tracking spreadsheets updated.
• Provides preliminary research on problems or activities requested by clinical staff and/or by the Lead Medical Management Nurse/Supervisor nd provides the information back to the requesting person for follow up, as appropriate.
• Makes administrative decisions only, completes appropriate actions functioning under the direction of clinical staff and the Lead Medical Management Nurse/Supervisor and within agreed upon limitations.
• Responds to general customer service questions or directs the caller to the appropriate person or department.
• May assist with answering front desk phones and/or be in back up rotation to Receptionist/Clerical.
• Performs other non-clinically related job duties as assigned.

QUALIFICATION REQUIREMENTS: 

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
• Knowledge of medical terminology CPT and ICD codes strongly preferred.
• Must be able to type minimum 40 wpm.
• Must possess organizational, non-clinically related problem solving and professional communication skills (verbal and written).
• Must be able to follow direction and applicable policies/procedures.
• Activities require prioritizing of non-clinically related daily tasks.

 EDUCATION and/or EXPERIENCE:

• High school diploma or equivalent required.
• Computer skills required with knowledge in utilizing Outlook, Microsoft Word, Excel and other databases.
• Prior medical assistant type experience and/or some knowledge of medical terminology.
• Minimum 1-2 years Workers’ Compensation experience or experience in a health related service field is helpful.
• Bilingual a plus.

Your employer reserves the right to modify the description of the duties and the requirements   of this job at any time upon reasonable notice.

AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.

AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.

AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.