Medical Management Support Specialist

Imagine360 is currently seeking a Medical Management Support Specialist to join the team! The Medical Management Support Specialist will assist the Medical Management Supervisor by supporting non-clinical tasks and / or projects as assigned.

Position Location :   100% remote

Duties / Responsibilities :

• Assist Medical Management Supervisor, Managers , and Clinicians with non-clinical tasks as instructed by the direct supervisor.
• Assigns cases to the appropriate clinical employee , following approved criteria for case assignment ; will also transfer non-clinical data as well as structure clinical data, as directed by clinical and non-clinical supervisor(s) .
• Communicates professionally with external providers and vendors to assist with case documentation , requesting clinical documents for clinical staff review .
• Following a script, c ompletes non-clinical outreach calls to clients to gather information related to program enrollment, as instructed by Supervisor.
• Assist s with Stop Loss communication by sending Stop Loss letters to the Stop Loss Carriers as instructed .
• Monitor specific department email inboxes and a ssign cases to clinical employee s and direct communications recei ved to the appropriate employee as instructed by Supervisor.
• Pull program satisfaction survey results and distribute to appropriate employees as needed.
• Run and assemble internal and external reports as instructed .
• Maintain inventory of education and resources for the team.
• Mail letters and education material for Medical Management programs to members.
• Process returned mail for Medical Management.
• Prepare & maintain new hire binders as needed.
• Help organize and attend scheduled meetings and trainings for the department or company via teleconference or in person.
• Process participant assessments as assigned .
• Work collaboratively within a team setting to provide positive outcomes for members, clients, peers, and overall operations.
• Performs all tasks in accordance with Medical Management policies and procedures and HIPAA / PHI guidelines and follows the policies and procedures as it relates to escalating issues within the staff hierarchy and between clinical and non-clinical staff.
• Complete s all tasks on time and with accuracy.
• Participate in quality program as assigned .
• Perform all tasks in accordance with HIPAA / PHI guidelines .
• Complete HIPAA training annually .
• Perform other duties as assigned .

Education and Experience :

Required Education :

Required Experience :

Preferred Experience :

Skills and Abilities :

Physical Requirements :

Work Environment :

Physical Demands

What can Imagine360 offer you?

Want to see our latest job opportunities? Follow us on LinkedIn

Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.

Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.