Managed Care Coordinator jobs in Kentucky

Volare Health is seeking an experienced and enthusiastic individual to join our outstanding team as a Managed Care/Insurance Biller!

Responsibilities:

• Authorization - Review and follow up with the facilities to ensure facility has received authorization to provide services to payers.
• Rate Changes - Ensure all rates are correct within the billing software. Entry of new rates as they are published within the various contracts.
• Billing Claims - Bill according to the outlined billing schedule as set by the Corporate Office. Billers will prepare, review, and transmit claims using billing software through electronic and paper claim processing.
• Claim Follow-up - Provide claim follow up based on claim review protocol. Contact providers through phone and online review of outstanding claims.
• Claim Research & Adjustments - Outstanding claims will be researched and reviewed until the AR payer has been relieved. Process refunds and adjustments according to guidelines.
• Claim Payment - Collect the payment EOB and process payment as indicated for patients' dates of service. Payments which are not equal to outstanding AR will be researched and reprocess for refunds, additional payment request, or adjustment needs.
• Communication - Employee will need to have effective communication with payers to resolve outstanding issues. Employee will also need to work effectively with facility personal to resolve issues for billing.
• Aging Review - Completes monthly aging for facilities and attends aging review meeting when necessary.

Qualifications:

• Billing experience in a long-term care, nursing home, or hospital setting