Professional Management Enterprises (PME)
51 - 200 employees
PME is a Minority and Service Disabled Veteran Owned Business founded in 2006, that is a highly valued teaming partner in multiple states to large corporations such as Humana, KPMG, Ernst and Young, Anthem, and HP to name a few. Additionally, we provide services in the areas of healthcare, IT, and professional services to Department of Defense and other Federal Government clients. We also are highly engaged in state work in our home state of Indiana, as well as multiple other states nationwide. We successfully leverage our abilities in Healthcare, Managed Care, IT, and Human Capital Services with our flexibility and robust performance.
Medical Management Specialist
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🔥 0 minutes ago
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Professional Management Enterprises (PME)
51 - 200 employees
PME is a Minority and Service Disabled Veteran Owned Business founded in 2006, that is a highly valued teaming partner in multiple states to large corporations such as Humana, KPMG, Ernst and Young, Anthem, and HP to name a few. Additionally, we provide services in the areas of healthcare, IT, and professional services to Department of Defense and other Federal Government clients. We also are highly engaged in state work in our home state of Indiana, as well as multiple other states nationwide. We successfully leverage our abilities in Healthcare, Managed Care, IT, and Human Capital Services with our flexibility and robust performance.
📋 Description
• Provides non-clinical support to medical management operations calls • Gathers clinical information regarding cases • Conducts initial review of files to determine appropriate action required • Maintains and updates tracking databases • Prepares reports and documents all actions • Responds to requests, calls or correspondence within scope • Provides general program information to members and providers as requested • May review and assist with cases • Acts as liaison between medical management operations and other internal departments
🎯 Requirements
• Requires a high school diploma • Minimum of 5 years administrative and customer service experience • Knowledge of managed care or Medicaid/Medicare concepts strongly preferred • Strong customer service/call center skills
🏖️ Benefits
• Medical, dental, and vision insurance offered • Supplemental insurace • 80 hours of PTO after 90 days • 10 paid holidays
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