Managed Care Coordinator jobs in Brandon, FL

Managed Care Coordinator coordinates utilization reviews of managed care contracts using established guidelines and processes. Ensures all clinical operations comply with Medicare and Medicaid guidelines and other managed care policies. Being a Managed Care Coordinator communicates with physicians, discharge planners and others to process referrals, authorization for services, and capture data related to utilization. Maintains managed care contracts and information databases and prepares reports. Additionally, Managed Care Coordinator typically requires an associate degree in nursing. Typically reports to a supervisor or manager. Typically requires Registered Nurse (RN). The Managed Care Coordinator has gained full proficiency in a broad range of activities related to the job. Independently performs a wide range of complex duties under general guidance from supervisors. To be a Managed Care Coordinator typically requires 5-7 years of related experience. (Copyright 2024 Salary.com)

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Managed Care Billing Specialist
  • Southwest Florida Home Care, Inc.
  • Tampa, FL FULL_TIME
  • : MANAGED CARE BILLING SPECIALIST


    • Perform initial audit on all charts within 24hours of QA approval
    • To follow up on and/or correct any issues found upon initial review in a timely manner
    • Run a daily discharge report to identify new discharge patients
    • Perform an EOE (final claim audit) on all discharged patients and patients who reached the end of their episode and will be continued within 48 hours
    • Update managed care billing spreadsheet daily with new discharges/items needed
    • Send e-mail weekly to all staff involved in resolving issues holding up final billing
    • Follow up with medical records, clinicians, QA, etc. to get tasks completed needed for billing on a daily basis
    • Run a daily “orders returned” report to identify signed orders/evals
    • To follow up on and/or correct any issues found upon final claim audit timely
    • Responsible for filing all managed care claims as directed by Billing Manager daily
    • Follow up on all denied/rejected managed care claims in a timely manner
    • Posting of managed care payments in Wellsky on a daily basis
    • Export of all managed care Oasis Assessments to State on a weekly basis
    • Follow up/inform Billing Manager of any issues stemming from Oasis Validation Reports same day
    • Partial training performing managed care eligibility checks/requesting auth / entering authorizations, in order to function as back up as needed
    • Keep Billing Manager informed on a daily basis of any issues/concerns related to any managed care charts/billing issues/oasis issues etc.

    REQUIRED SKILLS:

    • Exceptional follow up skills
    • Organized
    • Detail oriented
    • Able to multi-task
    • Able to work without supervision
    • Able to communicate well with authorization department and health plans
    • Ability to work well under pressure
  • 9 Days Ago

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Dental assistant
  • Centurion Managed Care
  • Bowling Green, FL FULL_TIME
  • Job Details Description Centurion is proud to be the provider of dental services to the Florida Department of Corrections. We are currently seeking a full-time Dental Assistant to join our team at Har...
  • 1 Month Ago

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Hospital Managed Care Contractor
  • Shriners Children's
  • Tampa, FL CONTRACTOR
  • Company Overview Shriners Children’s Hospital is an organization that respects, supports, and values each other. We are engaged in providing excellence in patient care, embracing multi-disciplinary ed...
  • 19 Days Ago

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Tampa, FL FULL_TIME
  • We are currently seeking a skilled and motivated Pharmacist with expertise in Pharmacy Benefit Management (PBM) and Managed Care. In this pivotal role, you will be responsible for overseeing medicatio...
  • 8 Days Ago

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MANAGED CARE CONTRACT MANAGER
  • Moffitt Cancer Center Careers
  • Tampa, FL FULL_TIME
  • At Moffitt Cancer Center, we strive to be the leader in understanding the complexity of cancer and applying these insights to contribute to the prevention and cure of cancer. Our diverse team of over ...
  • 28 Days Ago

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Managed Care Contract Manager
  • Shriners Hospitals For Children
  • Tampa, FL FULL_TIME
  • ID 2024-4647 Category Payer Relations Position Type Regular Full-Time Company Overview Shriners Children’s Hospital is an organization that respects, supports, and values each other. We are engaged in...
  • 1 Month Ago

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0 Managed Care Coordinator jobs found in Brandon, FL area

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RN. Care Coordinator
  • Chapters Health System
  • Brooksville, FL
  • It's inspiring to work with a company where people truly BELIEVE in what they're doing! When you become part of the Chap...
  • 3/29/2024 12:00:00 AM

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RN, Care Coordinator LifePath Hospice
  • Chapters Health System
  • Tampa, FL
  • It's inspiring to work with a company where people truly BELIEVE in what they're doing! When you become part of the Chap...
  • 3/29/2024 12:00:00 AM

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Patient Care Coordinator
  • Upperline Health
  • Clearwater, FL
  • About Us Upperline Health launched in 2017 and is one of the nation's leading comprehensive and coordinated lower extrem...
  • 3/28/2024 12:00:00 AM

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Wound Care Coordinator
  • Encompass Health Corp.
  • Largo, FL
  • The Wound Care Coordinator directs, organizes, and develops all wound care services in accordance with applicable federa...
  • 3/28/2024 12:00:00 AM

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Patient Care Coordinator
  • Align Foot & Ankle
  • Saint Petersburg, FL
  • Job Description Job Description Align Foot & Ankle, Office Coordinator - Full Time St Petersburg, Florida Dr. Zachery P....
  • 3/27/2024 12:00:00 AM

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Care Coordinator (Non-Dental)
  • HeadsUp Healthcare
  • Tampa, FL
  • Job Description Job Description Roles and Responsibilities: Ensure treatment is appropriately planned, scheduled and man...
  • 3/27/2024 12:00:00 AM

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Bilingual Care Coordinator/Front Desk
  • Healthpro Heritage, LLC
  • Tampa, FL
  • Overview: FRONT DESK/NEW PATIENT COORDINATOR (must be bilingual in English & Spanish) in North Tampa, FL Busy, fast-pace...
  • 3/27/2024 12:00:00 AM

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Home Care Pharmacy Care Coordinator
  • BayCare Health System
  • Largo, FL
  • **Theres home care and then theres BayCare HomeCare!** At BayCare, we are proud to be one of the largest employers in th...
  • 3/26/2024 12:00:00 AM

Brandon is an unincorporated community and census-designated place (CDP) in Hillsborough County, Florida, United States. It is part of the Tampa–St. Petersburg–Clearwater Metropolitan Statistical Area. As of the 2010 census, the CDP had a population of 103,483, up from 77,895 at the 2000 census. Brandon's census boundaries include Palm River-Clair Mel to the west across U.S. Route 301, Valrico to the east, Riverview and Bloomingdale to the south, and East Lake-Orient Park, Mango, and Seffner to the north. Brandon is 11 miles (18 km) east of downtown Tampa and 14 miles (23 km) southwest of Plan...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$47,222 to $81,042
Brandon, Florida area prices
were up 1.1% from a year ago

Managed Care Coordinator in San Francisco, CA
Care managers also sometimes provide case management--for example, information about transportation assistance, food programs, and other social services.
December 12, 2019
Managed Care Coordinator in Santa Barbara, CA
Nursing home administrators manage staff, admissions, finances, and care of the building, as well as care of the residents in nursing homes.
February 02, 2020
Managed Care Coordinator in Orange, CA
Assist with on-boarding and training of new Managed Care Coordinators.
January 20, 2020