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)
Cassena Care is seeking a Managed Care Medical Biller to join our dynamic team of professionals.
responsibilities include but are not limited to:
Collect, enter and process primary and/or secondary claim information on departmental cycle for multiple SNF locations.
Monitor verifications and authorizations obtained and ensure complete service spans are covered.
Answer business office manager and/or responsible party inquiries on account status and charges.
Researches and resolves all zero payment explanations or benefits and exercises all options to obtain claims payments; initiates adjustments as necessary.
Timely submission of SNF claims to various insurance companies
Prepares and generates clean claims for submission to all payor types, including third party payors, Medicare and Medicaid.
Develop and maintain working relationships with internal/external providers to ensure billings and collections procedures are current.
Monthly billing for all Commercial and Managed Care plans
Oversee authorization process to ensure accuracy
Create deposits weekly
Post cash to resident ledgers weekly
Follow up on all outstanding A/R
Qualifications:
High School Diploma/GED or equivalent required; Associates Degree or Medical Billing Certificate preferred.
Experience in area of billing, denials review, and accounts receivable processes required.
Medicaid and Managed Care Billing Experience
What we offer: Our organization offers employees far more than just a place to work. Rather, we are a company you can be proud of, where you’ll feel good about devoting your time and your talents.
Salary commensurate with experience
Generous PTO package
Health/Dental Benefits
401k plan
We are an EOE
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