Jobs

    managed care coordinator - Greensboro, NC, USA, United States - Cone Health

    Cone Health
    Cone Health Greensboro, NC, USA, United States

    1 week ago

    Default job background
    Description
    Overview


    This position is responsible for accurately analyzing, implementing and monitoring contractual relationships in support of Managed Care goals and objectives.

    Serves as a liaison between, Cone Health, Carolinas Health System and payers to accurately administer Managed Care contract terms, resolve problems, troubleshoot and provide customer service.


    Talent Pool:
    Corporate Services/Professional

    Responsibilities

    Implement the startup of newly negotiated managed care contracts.

    Oversee operational relationships with established managed care contractors Serve as an internal resource to operating divisions/departments in the interpretation and implementation of current and revised contract provisions.

    Manage the flow of information to the appropriate staff and facilitate problem resolution Assist with coding of contract databases, development, performance, and documentation of tasks for the appropriate contract management applications Coordinate electronic access to payer websites for Health System staff Monitors/trends contract/payer performance and outcomes for purposes of compiling summary data for administrative and managerial review Works with denial team and underpayment team to coordinate/administer appeal efforts for reimbursement not made in compliance with contract terms Assist in certain managed care efforts for hospital based staff physicians, psychologists and other professional providers

    Qualifications


    EDUCATION:
    Associates, Business Administration, RequiredBachelors, Business Administration, PreferredAssociate Degree in Business Administration, Accounting or a related field or equivalent work experience required; Bachelor's Degree preferred


    EXPERIENCE:
    3-5, Required6-7, PreferredMinimum of 3-5 years in a medical/insurance environment; 6-7 years preferred. Health Information Management with electronic medical records and EPIC experience preferred.


    LICENSURE/CERTIFICATION/REGISTRY/LISTING:
    REQUIREDN/APREFERREDN/A


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