Medpoint Management
Los Angeles, CA, USA
Job Description Job Description Summary Under the supervision of the Lead, NOA Operations the NOA Outpatient Coordinator II’s primary responsibility is to accurately prepare and process the Notice of Action letters for MPM’s assigned managed care members. Duties and Responsibilities · Review and process daily letter assignment requests (i.e. denials and modifications) · Comply with MPM/UM policies and procedures and regulatory standards (i.e., CMS, NCQA) to maintain a Notice of Action letter compliant with: a. Letter template accuracy b. Language accuracy c. Grade level literacy d. Provider and member notification timeliness · Comprehensive review of Medical Director and Clinician documentation to include all elements required to process the letter accurately: a. Criteria, policy, or EOC attachment accuracy b. Member’s authorization and claims history c. New approved authorization (if applicable) · Provide coverage for sub-teams (i.e. NOA packets, Carve Out...