Medical Management Assistant
FCCI Insurance Group is a trusted provider of comprehensive property & casualty coverage in 19 states. We are a successful and growing organization built on the strength of our guiding principles. Our mission, corporate philosophy and core values are all indicators of the ethical manner in which our employees conduct business every day. FCCI has a reputation for excellence in products, services and employees and its a great place to work!
Provide administrative assistance for the preparation of, and in some instances response to, claims to be reviewed for Utilization Review, Future Medical Cost Projections and Medicare Set-Aside Allocation, Pre-certification, Peer Review, Medicare Conditional Payments/Liens, and other requests from Regional claim staff or outside companies/agencies. Complete detailed and comprehensive monthly production reports and submit to management for review by designated timeframe.
This opportunity will also manage bill review and claim systems information, reconsideration of bills to include changes to claims, providers and payment information. The selected candidate will work with accounting and necessary personnel to process refunds, stop pays and void within the claims or bill review system. Provide feedback to management as needed.
The Medical Management Assistant will assist in any other special departmental activities or projects as requested. Provide customer service excellence and build provider and adjuster relationships by answering, researching and returning messages and requests in a helpful and timely manner. Utilize training / reference materials, tools and resources to assist customers during bill processing, projects, etc.
This opportunity is located in Sarasota, FL.Education and Qualifications
- High School Diploma (or Equivalent).
- CPC certification (or similar) strongly preferred.
- Minimum of two years of bill review experience or medical office or administrative experience.
- Minimum of two years of experience in an insurance environment.
- Intermediate working knowledge of medical terminology.
- Basic proficiency in accurate data entry and use of keyboard devices.
- Excellent communication, internal and external customer service, interpersonal skills, and organizational skills.
- Ability to multi-task and prioritize work, including flexibility with daily assignment/tasks.
- Ability to maintain a professional demeanor under pressure.
- Ability to resolve problems and maintain effective working relationships with all levels across both internal and external departments.
- Basic working knowledge of arithmetic.
- Ability to analyze data, use good judgment and make supported decisions.
- Basic understanding of utilization review, quality assurance, and departmental procedural guides.
- Basic knowledge of cost containment.
EOE/ Drug free workplace