View Our Website View All Jobs

MMC Operations Associate

Job Summary

GRG’s Medical Monitoring and Consulting is a service-oriented business unit  responsible for the administration of medical appointments and claim payments. Associates will work with internal and external stakeholders to deliver an excellent experience to all customers.

Responsibilities and Duties

  • Medical Appointment Management – Partners with our medical provider network to administer appointments.   Tasks would include the education of provider locations to enable them to implement program requirements.  Subsequent to provider onboarding, associates will ensure efficient appointment administration.
  • Claims Administration – Accurately and efficiently performs claim intake, adjudication, payment, and generation of provider and class member correspondence (e.g., explanation of payment and explanation of benefits).  

  • Program Liaison – Coordinates with other business units (enrollment, call center and payment teams) to achieve positive program results. Associates must ensure that program-related inquiries are managed accurately and timely.  

  • Claims Software Application – Serves as subject matter expert for all claims-related software applications.

  • Claims/Financial Reporting and Appointment Reporting – Generates required program reports accurately and on-time. 

  • Software User Acceptance Testing – Participates in user acceptance testing of the enterprise application under the direction of the MMC Operations Manager.

Core Competencies

  • Customer Focus – Provides customer satisfaction with diverse populations of internal and external customers, to include GRG employees, health care providers, claimants, and legal representatives.  Enjoys helping/serving others.
  • Productive – Able to remain focused and to perform large quantities of work accurately, though tasks may be repetitive at times.
  • Documentation Skills – Able to accurately document the current issue and subsequent actions. 
  • Timeliness – Can meet tight deadlines while not sacrificing quality.
  • Detail-oriented/Analytical – Performs work accurately and notices trends or deviations in data.  Capable of analyzing and managing large volumes of data.
  • Organized – Able to manage large volumes of data (claim forms, inquiries, emails) timely and accurately.
  • Accountability – Takes personal accountability for actions.  Can apply broadly articulated principles to specific situations while possessing the judgment to escalate issues to management when necessary.
  •  Integrity – Engenders trust at all levels.
  • Teamwork and Collaboration – Contributes to team success by working closely and collaboratively with teammates and across organizational boundaries.

Requirements

  • Bachelor’s degree and/or equivalent work experience.  Desired experience includes work in a healthcare setting, claims administration/processing, and/or program administration. 
  • Prior work experience in call center, healthcare organization, health insurance, employee benefits, or medical claims a plus. 
  • Proficient in Microsoft Outlook, Word, Power Point, and Excel required.  Proficiency  with SharePoint, Project, and/or Salesforce is a plus. 
  • Experience performing software user acceptance testing is a plus.
  • Effective communication skills – written, oral, and listening.
  • Possesses critical thinking and time management skills; strong work ethic; and the ability and willingness to learn and adapt.
  • Day consists of frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, navigating several computer applications, and long periods working at a computer.
  • Will work in a service center environment with moderate noise level.
  • Resilient; able to adapt to a fast-paced, high-stress environment
Read More

Apply for this position

Required*
Apply with Indeed
Attach resume as .pdf, .doc, or .docx (limit 2MB) or Paste resume

Paste your resume here or Attach resume file

150
To comply with government Equal Employment Opportunity / Affirmative Action reporting regulations, we are requesting (but NOT requiring) that you enter this personal data. This information will not be used in connection with any employment decisions, and will be used solely as permitted by state and federal law. Your voluntary cooperation would be appreciated. Learn more.
Gender
Race
Veteran/Disability status