Top Managed Care Executive plans and directs all aspects of an organization's managed care function. Responsible for directing and implementing managed care systems for healthcare facilities. Being a Top Managed Care Executive requires a bachelor's degree. Typically reports to a top management. The Top Managed Care Executive manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. To be a Top Managed Care Executive typically requires 8+ years of managerial experience. Comprehensive knowledge of the overall departmental function. (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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