Summary: National Managed Care Organization is a great place to work because we are committed to providing high-quality healthcare services and improving the lives of our members. We value our employees' contributions and offer opportunities for growth and development. Join our team and make a difference in the healthcare industry!

Job Description:

Position: Medical Assistant IV (Temp-to-Perm)
Pay: $36.00 per hour (You must have DRG Claims experience)

Location: Fully Remote - Must live in Eastern Time Zone

Schedule: Monday-Friday, 9AM-5PM (local time) Training Schedule: Monday-Friday, 9AM-5PM (EST)

Job Description: As a Medical Assistant IV at National Managed Care Organization, you will work under the supervision of the Medical Claims Review Nurse and receive cross-training to perform various tasks in different areas, including appeals, claims analytics, DRG Validation claims repricing, and outpatient payment integrity audit concepts.

Daily Responsibilities:

• Conduct non-clinical appeals reviews for overpaid claims.
• Perform repricing of identified claims to identify overpayment variances for DRG Validation claims.
• Demonstrate proficiency in State and Federal Regulatory programs and their required documentation processes necessary for claim payment.
• Ensure completion of patient visit documentation, including logs, patient charting, inventory, etc., by the provider and staff on the date of the patient visit.

Qualifications:

• Knowledge of all back office functions of a medical assistant in accordance with the MA scope of practice and protocol.
• DRG claims experience
• Required Education: High School Diploma or GED equivalent.
• Required Experience: Minimum of 5 years of Medical Assistant experience.
• Required Licensure/Certification: Graduate of a Medical Assistant program from a federally accredited, State-licensed vocational/technical school.

National Managed Care Organization is an equal opportunity employer and encourages a diverse and inclusive workforce. We are committed to providing our employees with opportunities for career advancement and professional development. Join our team and be a part of our mission to improve healthcare outcomes for our members.