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Financial Systems Management Specialist

2 months ago

Dubai, Dubai, United Arab Emirates Dice Full time
Job Summary

The Medical Authorization Assistant (MAA) plays a critical role in the healthcare industry, serving as a liaison between members, physicians, providers, and health insurance staff. This position requires strong communication and organizational skills, as well as the ability to work effectively in a fast-paced environment.

Key Responsibilities
  • Participate in a mission-driven culture of high-quality performance, focusing on customer service, consistency, dignity, and respect.
  • Assist the team in carrying out departmental responsibilities and collaborate with others to support short- and long-term goals and priorities.
  • Receive and process referral requests via various channels, entering new service request information into the authorization system.
  • Collect additional information from members and providers to complete referrals.
  • Authorize requested services according to authorization guidelines, performing data entry into the authorization system and verifying information.
  • Communicate with health networks and customer service regarding health network issues.
  • Assist the authorization nurse in gathering medical records, obtaining appropriate coding for diagnosis and procedures, and following up on phone calls as directed.
  • Document all contacts and case information in the system using standard charting.
  • Perform data entry into relevant databases for monitoring, tracking, and trending of events.
  • Complete other projects and duties as assigned.
Requirements
  • High School diploma or equivalent.
  • 2 years of experience in a healthcare or managed care setting.
  • An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position.
Preferred Qualifications
  • Bilingual in English and one of our defined threshold languages (English, Spanish, Vietnamese, Farsi, Arabic, Korean, and Chinese).
  • Prior authorization and utilization management process knowledge.
Knowledge of:
  • Medical terminology and concepts.
  • Medi-Cal and Medicare benefits and regulations.
  • Current ICD-10-CPT and HCPCS coding systems.