Elite Technical is seeking a Medical Management Coordinator (MMC) in the Maryland/Washington DC area for a hybrid opportunity with our client (3 days per week onsite).

The role of the MMC is to assist with:
- Triage and enter appeals with accuracy and urgency
- Process medical records requests and prepare overturn notices
- Build shell cases in GuidingCare and draft appeal letters
- Route final decisions and generate/mail letters and FFRNs
- Monitor the adjustment queue to keep cases moving
- Notify providers the same day decisions are made, keeping communication fast and reliable

This is a contract position (6 months) and requires a working laptop to bring onsite to the customer location.

Required Skills

- HS Diploma is required, along with a minimum 2 years experience in health care/managed care setting or previous work experience within division
- Knowledge of CPT and ICD-10 coding, previous appeals, ability to review letter of appeal, identify claims is required.
- Must have Healthedge GuidingCare experience
- Must have Facets experience (Legacy and/or G6).
- NASCO is a plus.
- Lotus Notes (now HCL Notes) is a plus