Managed Care Coordinator jobs in Wilmington, NC

Purpose:

Processes all referral forms and answers all patient and employee questions regarding previously requested authorization

Essential Duties/Responsibilities:

Other Duties:

As assigned by manager

Qualifications:

Required:

High school diploma, GED, or high school equivalency

3 to 5 years' experience in a medical office environment;

or equivalent combination of education and experience.

Managed Care Coordinator Competencies

General

• Customer Service
• Professionalism/Integrity/Responsibility
• Teamwork/Process Focus
• Dependability/Punctuality
• Interpersonal Relationships/Communication
• Judgment/Decision Making/Problem Solving
• Quality/Quantity
• Initiative
• Safety/Housekeeping
• Organizational Skills/Time Management

Department Specific

• Processes all pre-certs and prior authorizations within 48 hours for evaluate and treats.
• Processes all surgeries and procedures five days prior to appointment.
• Completes all retro requests within five days.
• Processes all mail and correspondence on a daily basis.
• Copies monthly Medicaid enrollment for all locations by the fifth of each month.
• Maintains up-to-date information re: managed care plans. Distributes necessary updates to staff/management.