MSLA is a Medical Corporation that provides comprehensive independent medical evaluations (IME) and other IME related services to the government and private industry. Our business philosophy incorporates both exceptional customer service and quality evaluations, both of which are the primary factors for our rapid growth since our inception in 1998. No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. And you'll do your life's best work.(sm) Primary Responsibilities: Manage administrative intake of members or the admission/discharge information post notification Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and/or providers Manage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles Receive care coordination notification cases for non-clinical assessment/intervention and provide appropriate triage Review requests for adverse determination, approval notification and processing notification requirements Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review Handle resolution/inquiries from members and/or providers that may include: Benefit and Eligibility information Billing and Payment issues Customer material requests Physician assignments Authorization for treatment Explanation of Benefits (EOB) Verifying appropriate ICD-9 and CPT coding usage
Required Qualifications: HS Diploma or GED 2+ years of customer service experience analyzing and solving customer problems Must be able to create, edit, save and send documents utilizing Microsoft Word and Excel Must be able to navigate a PC to open applications, send emails, and conduct data entryPreferred Qualifications: Experience working within the Healthcare Industry Experience working with Healthcare Insurance Experience working in a Hospital, Physician's Office, or Medical Clinical setting. Professional experience in a clerical or administrative support related role Working Knowledge of Medical Terminology to communicate with members and providers Experience working with ICD-9 and CPT codes Experience working with Medicare and/or Medicaid Services Experience working in a call center environmentCareers with MSLA. Our focus is simple. We're innovators at providing technology - driven, comprehensive, independent medical evaluations to government and private entities. In addition to our core clinics located throughout California, Nevada and Hawaii, we manage an extensive nationwide network of fully credentialed physicians in all major specialties. We've joined Optum, part of the UnitedHealth Group family of businesses. And when you join our team, you'll impact the lives of others by verifying the validity of claims, providing quality examinations and meeting the timelines that make a difference for our customers. Here, you'll join a team that makes you want to do better every day, resulting in your life's best work.(sm) https://www.mslaca.com/Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Diagnostic, Case, Technician, Veteran, Medical, Cypress, CA, California
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.