Managed Care Coordinator coordinates utilization reviews of managed care contracts using established guidelines and processes. Ensures all clinical operations comply with Medicare and Medicaid guidelines and other managed care policies. Being a Managed Care Coordinator communicates with physicians, discharge planners and others to process referrals, authorization for services, and capture data related to utilization. Maintains managed care contracts and information databases and prepares reports. Additionally, Managed Care Coordinator typically requires an associate degree in nursing. Typically reports to a supervisor or manager. Typically requires Registered Nurse (RN). The Managed Care Coordinator has gained full proficiency in a broad range of activities related to the job. Independently performs a wide range of complex duties under general guidance from supervisors. To be a Managed Care Coordinator typically requires 5-7 years of related experience. (Copyright 2024 Salary.com)
PRIMARY FUNCTION
• Cash application and daily deposit reports
• Refund and write off processing
• Scanning and filing
• Perform other special projects as needed
RESPONSIBILITIES
• Review incoming mail and check sorting
• Post cash application, run daily deposit reports
• Investigate payment discrepancies
• Process overpayment refunds to clients
• As needed, run specific departmental reports
• Filing of accounts payable documents
• Review own work for quality assurance purposes
• Assist other team members with special projects as needed
EDUCATION, EXPERIENCE, SKILLS
• High school diploma or equivalent
• Minimum 2 years experience working in finance environment
• Strong data entry skills
• Excellent record keeping skills
• Detail oriented and reliable
• Ability to multi-task and work independently
• Good communication skills
• MS Office software knowledge a plus with emphasis on Excel
• Regular and timely attendance is required
First Managed Care Option, Inc., is an Equal Opportunity Employer and takes pride in maintaining a diverse environment. We do not discriminate in recruitment, hiring, training, promotion, or any other employment practices for reasons of race, color, religion, gender, national origin, age, sexual orientation, marital or veteran status, disability, or any other legally protected status.
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