- Responsible for entering payer contracts/rates for the practices into practice management system.
- Maintains and coordinates updates from payers to contract fee schedules within the Practice Management System.
- Audits managed care contracting rates and terms in management system ensuring rates are accurate and complete to contract.
- Provides contract summary sheets to revenue cycle staff regarding health plan limitations and restrictions.
- Monitors and communicates contract changes to revenue cycle staff. Answers routine and general contract term questions.
- Monthly, produces managed care paid claims reports. Reviews reports and verifies that paid claims are in compliance with contracted rates.
- Contacts third party payers to resolve issues and submits appeal in order to obtain outstanding payments.
- Tracks payer denial trends and notifies management of significant changes.
- Updates and maintains current provider licensure files for contracted physicians, practitioners, and nurses.
- Completes state medical license applications and payments to appropriate agencies ensuring applications are accurate, complete, and filed timely.
- Follows-up with state medical licensure boards on status of license applications.
- Notifies providers of any licensure expirations.
- Maintains contracting metrics and runs appropriate reports to obtain statistics.
- Drafts presentations and materials for contracting meetings.
- Other duties as requested or assigned.
- High school diploma or equivalent required.
- Minimum of four (4) years combined medical billing and payment experience required.
- Medical coding experience required.
- Proficiency with computer systems and MicroSoft Office (Word, Power Point, and Excel) required.
- Working knowledgeable of state, federal, and third party claims processing required
- Must successfully complete required e-learning courses within 90 days of occupying position.
-
Managed Care Coordinator
3 days ago
US Oncology Network-wide Career Opportunities Evansville, United StatesOverview Employment Type: Full Time · In-Office Position · Benefits: M/D/V, Life Ins., 401(k), PTO, Paid Holidays · Evansville, IN · JOB SCOPE: Under general supervision, provides administrative support to managed care function by auditing and maintaining managed care contrac ...
-
Managed Care Coordinator
1 week ago
Regional Business Office Evansville, United StatesOverview: · Employment Type: Full Time · In-Office Position · Benefits: M/D/V, Life Ins., 401(k), PTO, Paid Holidays · Evansville, IN · JOB SCOPE: Under general supervision, provides administrative support to managed care function by auditing and maintaining managed care con ...
-
Managed Care Coordinator
1 week ago
The US Oncology Network Evansville, United StatesOverview:Employment Type : Full Time In-Office Position Benefits : M/D/V, Life Ins., 401(k), PTO, Paid Holidays Evansville, IN JOB SCOPE: Under general supervision, provides administrative support to managed care function by auditing and maintaining managed care contract requirem ...
-
Managed Care Coordinator
6 days ago
US Oncology Evansville, United StatesOverview Employment Type: Full Time In-Office Position Benefits: M/D/V, Life Ins., 401(k), PTO, Paid Holidays Evansville, IN JOB SCOPE: Under general supervision, provides administrative support to managed care function by auditing and maintaining managed care contract requiremen ...
-
Home Therapy Registered Nurse
1 day ago
Fresenius Medical Care Evansville, United States Full timeAbout this role: As a Home Therapies Registered Nurse, you will manage patient care in an independent home therapy program by providing education and support to patients and caretakers who have chosen to dialyze in the comfort of their home. This role is primarily clinic based, y ...
-
Home Care Coordinator
1 week ago
AcuteCare Health System Owensboro, United StatesWe are so excited to announce that BoldAge PACE has two new locations in Owensboro, KY and Evansville, IN. · We are currently looking for a Home Care Coordinator to join our team · About Us · BoldAge delivers innovative, creative solutions for PACE (Program of All-Inclusive Care ...
-
Home Care Coordinator
6 days ago
BoldAge PACE Owensboro, United StatesJob Description · Job DescriptionWe are so excited to announce that BoldAge PACE has two new locations in Owensboro, KY and Evansville, IN. · We are currently looking for a Home Care Coordinator to join our team · About Us · BoldAge delivers innovative, creative solutions for PA ...
-
Senior Physician
1 week ago
ZephyrTech Darmstadt, United StatesFor a client in North Rhine-Westphalia, we are currently looking for a senior physician (m/f/d) in the field of gastroenterology. · The primary and standard care provider has approximately beds divided into about 5 stations. Nearly outpatient and inpatient patients are treated th ...
-
Employee in Customer Service
2 weeks ago
Sapphire Technologies Parkers Settlement, IN, United States Freelance**Innovative, dynamic, creative - that's who we are** · At Medical Hair Company, communication and marketing are at the heart of everything we do. We plan, coordinate, and analyze marketing campaigns, develop advertising concepts and content strategies, produce content, and manag ...
-
HealthEcareers - Client Evansville, United States Full timeCome live and practice in one of the largest cities in Indiana. This is an excellent location with a low cost of living and the low crime rates. It is located along the Ohio River and the downtown is contemporary and attractive with historic areas and shops near the waterfront.Yo ...
-
Peer Recovery Coach
1 week ago
Acadia Healthcare Evansville, United StatesSeeking: Peer Recovery Coach - Outpatient MAT · Full Time Schedule: Monday - Friday 4:30 AM - 1:00 PM. · Our Benefits: · Quarterly Bonus Program · Medical, Dental, and Vision insurance · Competitive 401(k) plan · Paid vacation and sick time · STAR LRP Student Loan Forgiveness · ...
-
Client Coordinator
1 week ago
Maxim Healthcare Evansville, United StatesThe Client Coordinator works with clients, patients and active caregivers to identify open shifts, availability, and coordinate schedules. The Client Coordinator understands the needs, requirements, and preferences of all client types (patients, facilities, referral sources, care ...
-
Peer Recovery Coach
1 week ago
Acadia Healthcare Inc. Evansville, United StatesOverview · Seeking: Peer Recovery Coach - Outpatient MAT · Full Time Schedule: Monday - Friday 4:30 AM - 1:00 PM. · Our Benefits: · * Quarterly Bonus Program · * Medical, Dental, and Vision insurance · * Competitive 401(k) plan · * Paid vacation and sick time · * STAR LRP Student ...
-
licensed practical nurse
1 day ago
ResCare Community Living Evansville, IN, United StatesOur Company: · ResCare Community Living · Overview: · Works under the supervision of a Registered Nurse. Duties include providing routine care, general observation of client's health status, assists the RN and physician in treatments and communicating with clients and their famil ...
-
Clinical Quality Improvement Analyst
1 week ago
Deaconess Health System Evansville, United StatesJoin Our Team We are looking for compassionate, caring people to join our talented staff of health care professionals as we continue to grow to be the preferred, regional health care partner in our community. Job Overview The Clinical Quality Improvement Analyst (CQIA) serves as ...
-
Clinical Quality Improvement Analyst
6 days ago
Deaconess Health System Evansville, United StatesJoin Our Team We are looking for compassionate, caring people to join our talented staff of health care professionals as we continue to grow to be the preferred, regional health care partner in our community. Job Overview The Clinical Quality Analyst is responsible for the collec ...
-
Clinical Quality Improvement Analyst
1 week ago
Deaconess Health System Evansville, United States# # Join Our Team We are looking for compassionate, caring people to join our talented staff of health care professionals as we continue to grow to be the preferred, regional health care partner in our community. Job Overview The Clinical Quality Analyst is responsible for the co ...
-
BrightSpring Health Services EVANSVILLE, United StatesResCare Community Living · Our operational team members focus on efficiently meeting the needs of our clients across various lines of business. If your passion is to ensure quality care to help our clients live their best life we encourage you to apply today · Ensures consumer an ...
-
RN Med/Surg
1 week ago
Sigma Inc Evansville, United StatesASC RN Med/Surg - Evansville, IN - 13 Weeks contract · Sigma healthcare team is looking for Registered Nurse Med/Surg to work onsite in Evansville, IN. · Shift: 06:30 - 19:00 · Position Responsibilities: · Med/Surg Nurses provide direct and individualized nursing care to patien ...
-
Res-Care, Inc. Evansville, United StatesOur Company · ResCare Community Living · Overview · Our operational team members focus on efficiently meeting the needs of our clients across various lines of business. If your passion is to ensure quality care to help our clients live their best life we encourage you to apply to ...
Managed Care Coordinator - Evansville, United States - The US Oncology Network
Description
Overview:
Employment Type : Full Time
In-Office Position
Benefits : M/D/V, Life Ins., 401(k), PTO, Paid Holidays
Evansville, IN
JOB SCOPE: Under general supervision, provides administrative support to managed care function by auditing and maintaining managed care contract requirements in computer system, running standard reports, resolving contract errors, and answering routine contract questions. Processes provider credentialing and licensure applications ensuring all licensures are current. Supports and adheres to The US Oncology Compliance Program, to include the Code of Ethics and Business Standards, and The US Oncology's Shared Values.
The US Oncology Network is a thriving organization that fosters forward-thinking, advancement opportunities, and an inspired work environment. We continuously look for top talent who will continue to propel our organization in the right direction and celebrate new successes Come join our team in the fight against cancer
About US Oncology
The US Oncology Network is one of the nation's largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care. For more information, visit . We extend an extremely competitive offering of benefits to employees, including Medical Health Care, Dental Care, Vision Plan, 401-K with a matching component, Life Insurance, Short-term and Long-term disability, and Wellness & Perks Programs.
Responsibilities:
ESSENTIAL DUTIES AND RESPONSIBILITIES:
MINIMUM QUALIFICATIONS:
WORK ENVIRONMENT: The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.