Medical Management Examiner - Hybrid

Medical Management Examiner - Hybrid Auxiant - 3.4 Cedar Rapids, IA Job Details 1 day ago Benefits Paid holidays Disability insurance Health insurance Dental insurance Vision insurance Gym membership Life insurance Qualifications Research Math Decision making Full Job Description https://www.auxiant.com/

Auxiant's Mission Statement and Core Values Mission:

An Independent TPA investing in People and Innovation to deliver expert-driven experiences with REAL Results.

Core Values:

Independent Solutions. REAL Results R espect E mpowerment A gility L eadership Be part of a growing and prospering company as a Medical Management Examiner . Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, IA, Madison and Milwaukee, WI. Auxiant is a fast-growing, progressive company offering an excellent wage and benefit package.

Job Summary:

Serve as a liaison for Auxiant Medical Management (AMM) program. This position provides critical coordination and communication surrounding all moving parts of cost containment and medical management for our customer plans. The individual must be able to make sound decisions on partner recommendations based on the best interest of the client and participants and consistent with the plan document. The position will also work closely with the Medical Management Supervisor in a supportive roll. The individual will need to be efficient, accurate and excellent at multi-tasking. d exceptional organizational support. This position requires a reliable person who thrives in a fast-paced environment, manages competing priorities, and consistently delivers satisfactory work.

Essential Functions:

Review High Dollar Claims and vendor recommendations and apply decisions based on the Plan Document, stop loss insurance, ppo contracts, etc. Make clear and concise decisions in the best interest of client and the plan participant Run reports for claim suspends and reconciliation for Accounts Payables Coordinate with Claims surveillance partners Claims processing, research and customer service Data-entry Manage all aspects of daily processes and accurately identify and present issues to vendors that will optimize the AMM program.

Nonessential Functions:

Other duties as assigned or appropriate

Education/Qualifications:

High school diploma and 2-4 years related experience; or Associates or Bachelor's degree with some related experience General understanding of medical terminology & claims examiner experience The ability to work independently. The ability to load balance work. Proficient PC skills including e-mail, record keeping, routine database activity, word processing, spreadsheet,10-key Proven experience in a professional office environment Outstanding written and verbal communication skills Excellent mathematics and analytical skills Full benefits including: Medical, Dental, Vision, Flexible Spending, Gym Membership Reimbursement, Life Insurance, LTD, STD, 401K, 3 weeks vacation, 9 paid holidays, casual dress code and more