Description
We're building a world of health around every individual , shaping a more connected, convenient, and compassionate health experience.
Job Summary: This is a full-time Medical Coordinator role located in Ohio, working from home. The successful candidate will support comprehensive coordination of medical services, promote quality effectiveness of Healthcare Services, and perform intake of calls from members or providers regarding services.
Key Responsibilities:
- Supports comprehensive coordination of medical services, including intake, screening, and referrals
- Promotes and supports quality effectiveness of Healthcare Services
- Performs intake of calls from members or providers regarding services via telephone, fax, EDI
- Utilizes Aetna system to build, research, and enter member information
- Screens requests for appropriate referral from medical services staff
- Approves services that do not require a medical review in accordance with the benefit plan
- Performs non-medical research, including eligibility verification, COB, and benefits verification
- Maintains accurate and complete documentation of required information
- Promotes communication, both internally and externally, to enhance effectiveness of medical management services
- Protects the confidentiality of member information and adheres to company policies regarding confidentiality
Requirements:
- 1-2 years' experience working as a medical assistant, office assistant, or other clinical/equivalent experience
- High School Diploma, GED, or equivalent experience
- Associates degree preferred
Preferred Qualifications:
- Call center experience, 1-2 years
- Prior authorization experience, 1-2 years
Benefits: This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Pay Range: $17.00 - $31.30 per hour