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managed care coordinator
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Cone Health Greensboro, NC, USA, United StatesOverview · 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 Ca ...
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ed patient care support coordinator
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ed patient care support coordinator
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ED Patient Care Support Coordinator
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SanStone Health & Rehabilitation Greensboro, NC , USA, United StatesSanStone Health & Rehabilitation - Ashton Health and Rehabilitation is currently seeking a Staff Nurse to join our team of dedicated health care professionals. · Applicant must have unrestricted RN / LPN license. · Under the direction and supervision of the Director of Nursing, ...
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or rn specialty coordinator
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home care physical therapist pt
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Cone Health Greensboro, NC, USA, United StatesOverview · Assesses, plans, implements, documents, organizes prioritize, delegates, supervises and coordinates the care of neonatal, pediatric, adolescent, adult, geriatric as prescribed within parameters of the NC Nurse Practice Act. · Talent Pool: Nursing · Job Level: Registere ...
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Managed Care Coordinator - Greensboro, United States - Cone Health
Description
Managed Care Coordinator
ID
Location
Cone Health
Work Location
US-NC-Greensboro
Division :
Name
System Wide
Department :
Name
SW-Pt Acct Rev Integrity
Category
PROFESSIONAL/MNGMNT
Position Sub-Category
PROFESSIONAL/MNGMNT
Position Type
Full Time (40 hours/week)
Employment Type
Employee
Exempt/NonExempt
Exempt
FTE
1.00
Workforce Status
Hybrid I
Work Hours
40.00
Provider Schedule (specific schedule)
M-F, 8-5
On call Required
No
Sub Category
Professional/Management
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, Required
Bachelors, Business Administration, Preferred
Associate Degree in Business Administration, Accounting or a related field or equivalent work experience required; Bachelor's Degree preferred.
EXPERIENCE: 3-5, Required
6-7, Preferred
Minimum 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: REQUIRED
N/A
PREFERRED
N/A
