Medical Assistant (3753)
Medical Administrative Support Specialist | Harrisburg, PA | Contract
Work Location: Harrisburg, PA
The Medical Assistant will receive assignments verbally or in writing and will be carried out independently with minimal direct supervision. In this role, the selected candidate will work at one or more of the Department’s work sites. If you meet the qualifications, please apply and a Recruiter will reach out to you and answer any questions you may have.
Job Duties/Responsibilities/Functions(including but not limited to)
• Review provider enrollment applications for completeness. Scan and quality review of documents. Mail distribution. Perform provider credentialing by checking databases.
• Attends, maintains and distributes file notes for Department meetings. Maintains file notes for division meetings. Maintains Departmental Reports ensuring timeliness by tracking completion dates.
• Reviews new and revised policies and procedures related to the Medical Assistance Program. Reviews revisions to policies and procedures related to the MA program and processes.
• Answers the Department’s provider hotline calls by responding to inquiries specific to, but not limited to, Medical Assistance Program provider billing, claims submissions, and payment policies, third party liability, recipient eligibility, prior authorization, and MA regulations. Responds to, analyzes, and resolves incoming inquiries from providers and/or recipients. Directs callers and makes referrals. Maintains a log of all call outcomes in a call tracking database. Monitors provider hotline call times and queue. Previous call center experience a plus. Conducts outbound calls to address prior inquiries not resolved during initial contact.
• Reviews prior authorization requests to include checking for recipient eligibility, prior authorization and claims history, and determine if recipient is enrolled in a Managed Care Organization. Enters decisions from dental consultant. Checks prior authorization inventory. Prepares recipient appeal information to be sent to the bureau of hearings and appeals. Responds to voice mail messages from recipients regarding prior authorization requests.
• Distributes prior authorization charts received in the mail for medical review to assigned staff.
• Reviews exception requests from providers following criteria outlined in the Medical Assistance regulation and Program Bulletins. Makes administrative determinations to approve or deny requests. Enters decisions into the claims processing system. Prepares paperwork for the Bureau of Hearings and Appeals when final decision is appealed by the provider. Performs hearings with providers as necessary.
• Administrative responsibilities include sorting and date stamping mail and filing. Purging medical records and/or documentation for filing and records retention when needed. Receiving and distributing Departmental faxes. Performs other duties as assigned
• Possess certification or completion of a medical terminology or coding course.
• Demonstrate an understanding of basic medical terminology.
InGenesis is dedicated to placing people in positions that preserve life, improve lives and inspire others. This does not happen without passionate people, skilled colleagues who are motivated to create innovative solutions and deliver superior service to our clients. Founded in 1998, InGenesis manages thousands of employees, including pioneering healthcare, science, technology and pharma professionals. The workforce solutions company includes almost half of the Fortune 500 in its nearly 300 clients. It is recognized as one of the largest healthcare staffing firms, and InGenesis is the largest minority/women owned healthcare staffing firm in North America.
We support a diverse workforce and is an Equal Opportunity Employer who does not discriminate against employees and applicants for employment on the basis of race, gender, color, religion, national origin, age, sexual orientation, gender identity, genetic information, disability, veteran status, or other classification protected by law.