Managed Care Finance Director directs and oversees all policies and procedures for the financial and data operations of managed care contracts. Manages contracts, negotiates and sets rates, and reviews reimbursement levels and managed care agreements to ensure that proper payment practices are utilized. Being a Managed Care Finance Director implements processes that encourage and inform the organization how to increase levels of reimbursements. Requires a bachelor's degree. Additionally, Managed Care Finance Director typically reports to top management. The Managed Care Finance Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Managed Care Finance Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
This is a remote position. This is for the Managed Care team.
The working hours are Monday-Friday, 8:00am -4:30pm, EST or CST.
Summary: The Insurance Reimbursement Specialist, under the direction of Accounts Receivable Manager, ensures claims submitted to responsible entities are received, processed, and resolved in a timely manner. This position’s goals are met through professional communication, confidentiality and adherence to HIPAA guidelines, and a working knowledge of CMS/other payer guidelines.
Essential Duties and Responsibilities: (List in order of importance or percentage of time spent on the particular responsibility. High to Low)
Qualifications:
Required Education: High school diploma or equivalent
Required Experience: 1 year of experience in healthcare revenue cycle or business office.
Required License/Registration/Certification: None
Reasoning Ability:
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables. Use reasoning to meet and maintain department and personal benchmarks.
Computer Skills:
To perform this job successfully, an individual should have knowledge of Word Processing software, spreadsheet software and database software.
Physical Demands:
In order to successfully perform this job, with or without a reasonable accommodation, the following are outlined below:
The Employee is required to read, review, prepare and analyze written data and figures, using a pc or similar and should possess visual acuity.
The Employee may be required to occasionally climb, push, stand, walk, reach, grasp, kneel, stoop, and/or perform repetitive motions.
The Employee is not substantially exposed to adverse environmental conditions and therefore job functions are typically performed under conditions such as those found in general office or administrative work.
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