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Medical Management Specialist
Professional Management Enterprises (PME)Medical Management Specialist providing non-clinical support to medical management operations. Responsibilities include handling complex inquiries, maintaining databases, and liaising with internal departments.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in administrative support and customer service within medical management operations, with a strong understanding of managed care and Medicaid/Medicare concepts.
Highest-signal resume keywords
Administrative ExperienceCustomer Service SkillsManaged Care KnowledgeMedicaid/Medicare ConceptsDatabase Management
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
File ReviewReport PreparationDatabase TrackingCase Management
Soft Skills
Communication SkillsInterpersonal Skills
Certifications & Qualifications
High School Diploma
Industry Keywords
Medical Management OperationsCall Center Experience
About the role
Key responsibilities & impact- 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
What you’ll need- 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
Comp & perks- Medical, dental, and vision insurance offered
- Supplemental insurace
- 80 hours of PTO after 90 days
- 10 paid holidays