Heathcare/ Medical Management Coordinator

Title: Medical Management Coordinator

Location: Baltimore, MD 21224 (Hybrid)

Duration: 6 Months Contract

Job Description:

• Terms of Employment
• W2 Contract, 6 Months
• Hybrid: 1–2 days on-site per week; regular weekly in-office presence required)
• Work Hours: Full-time, 40 hours/week (Core hours: 8:00 AM – 5:00 PM)

• Overview
• Client is seeking detail-oriented Medical Management Coordinators to join a leading healthcare organization’s Clinical Appeals and Analysis Unit (CAU) in Canton. This role provides non-clinical operational and administrative support to streamline clinical appeals, case processing, and documentation. Working alongside a dedicated team of clinical analysts and nurses, you will play a crucial role in managing case entries, generating overturn notices, processing medical records requests, and managing physical mailings.

• Key Responsibilities
• Prepare, manually print, and package full-on fair appeal cases and letters for shipment through the on-site mailroom via FedEx.
• Assist with creating shell cases and entering case details into internal systems based on unit needs.
• Review and determine if medical records are required for specific appeal cases and facilitate request fulfillment.
• Draft, review, and print standardized overturn notices and related case documentation.
• Perform initial triaging of incoming documentation to verify appropriateness for clinical appeals processing.
• Utilize core healthcare administration platforms (GuidingCare and Facets) to navigate patient and claim details.
• Collaborate with clinical analysts and supervisor team members to maintain workflow efficiency during core business hours.

• Required Skills & Experience
• 2+ years of administrative or operational experience within a healthcare, managed care, or health insurance environment.
• Demonstrated experience navigating healthcare system platforms, specifically GuidingCare (Legacy or G6) and Facets.
• Familiarity with healthcare claims, clinical appeals, or Utilization Management (UM) processes.
• Practical knowledge or exposure to medical coding conventions, including CPT and ICD (ICD-9 / ICD-10) terminology.
• Local residency near the Canton location with full availability to work on-site 1–2 days per week as scheduled.

• Preferred Skills & Experience
• Previous experience in a medical billing, claims processing, or provider office setting.
• Familiarity with NASCO, Lotus Notes, or Explanation of Benefits (EOB) lookup systems.
• Prior experience handling confidential medical records, overturn notices, or legal appeal document packaging.