Managed Care Coordinator jobs in Knoxville, TN

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)

H
Managed care specialist
  • HealthEcareers - Client
  • Maryville, TN FULL_TIME
  • MANAGED CARE SPECIALIST JOB SUMMARY

    A Managed Care Specialist reviews all hospital / physician payment variances and prepares and files appeals or otherwise works with payer to ensure full payment according to contract for services provided.

    Identifies trends with third party payers as well as in-house activity that results in payment variances and offers opportunities for process improvement.

    Works closing with Billing / Follow Up, Case Management, and Patient Access.

    MANAGED CARE SPECIALIST JOB SPECIFICATIONS

    • two (2) years experience as a Patient Account Rep II, Credit Analyst; one (1) year experience as a Patient Account Rep I;

    or equivalent experience. Experience in hospital / physician billing, Managed Care contracts, customer service, insurance benefit verification and precertification preferred.

    KNOWLEDGE : Requires thorough knowledge of insurance company processes and insurance contract reimbursement methodology as well as fundamental understanding of hospital / physician fee schedules and how they apply contractually.

    Requires in depth knowledge of medical coding affecting adjudication of UB-04 claims, including; APC, ICD, CPT, HCPCS, DRG, and revenue code structures.

    SKILLS : Requires analytical problem solving skills to organize / assess information based on data collected; Critical thinking, judgment, and decision making skills are essential;

    Requires excellent computer skills in various information systems; Requires excellent verbal, mathematical, and written communication skills.

    ABILITIES : Requires an ability to work independently and gain assistance from multiple sources; Requires an ability to integrate information and make decisions;

    Requires an ability to provide consistent, effective follow-up and documentation; Requires an ability to effectively with departments in a team environment.

    Ability to communicate professionally and thoroughly with staff, patients, insurance companies, business partners and other parties.

    Competitive Pay and Benefits

    Health, dental and vision insurance

    Retirement plan with matching

    Flexible Savings Account (FSA)

    Disability insurance

    Life Insurance

    Paid sick time

    Paid time off

    Paid training

    Referral program

    Tuition reimbursement

    Employee Assistance Program

    PI238194793

    Compensation Information :

    $0.0 / - $0.0 /

    Starting At : 0.0

    Up To : 0.0

    Last updated : 2024-03-22

  • 4 Days Ago

C
Care Coordinator
  • Camelot Care Centers, LLC of Tennessee
  • Maryville, TN FULL_TIME
  • About your Role The Care Coordinator I provides intervention, manages client cases and acts as a resource link to children and families who desperately need assistance. Assist in case Management of ch...
  • 4 Days Ago

C
Care Coordinator
  • Camelot Care Centers, LLC of Tennessee
  • Morristown, TN FULL_TIME
  • About your Role The Care Coordinator I provides intervention, manages client cases and acts as a resource link to children and families who desperately need assistance. Assist in case Management of ch...
  • 5 Days Ago

C
FPS Care Coordinator
  • Camelot Care Centers, LLC of Tennessee
  • Jacksboro, TN FULL_TIME
  • Family Preservation Care Coordinator Are you searching for a way to use your compassion, knowledge and interpersonal skills? Camelot Care Centers, part of the national Pathways brand of mental health ...
  • 7 Days Ago

C
Behavioral Health- Care Coordinator
  • Camelot Care Centers, LLC of Tennessee
  • Oneida, TN FULL_TIME
  • Behavioral Health Care Coordinator Are you searching for a way to use your compassion, knowledge and interpersonal skills? Camelot Care Centers, part of the national Pathways brand of mental health pr...
  • 13 Days Ago

C
Family Preservation Services- Care Coordinator
  • Camelot Care Centers, LLC of Tennessee
  • Knoxville, TN FULL_TIME
  • Family Preservation Care Coordinator Are you searching for a way to use your compassion, knowledge and interpersonal skills? Camelot Care Centers, part of the national Pathways brand of mental health ...
  • 1 Month Ago

Filters

Clear All

  • Filter Jobs by companies
  • More

0 Managed Care Coordinator jobs found in Knoxville, TN area

R
Case Manager / Care Coordinator _ Social Services
  • Ridgeview Behavioral Health Services
  • Oak Ridge, TN
  • RIDGEVIEW Behavioral Health Services, a not-for-profit community mental health center, has an immediate opening for a Fu...
  • 3/28/2024 12:00:00 AM

C
Patient Care Coordinator/ Phone Receptionist
  • Carlson Eyecare Centers
  • Knoxville, TN
  • Job Description Job Description Carlson Eyecare Centers is a growing multi-office optometry practice based in East Tenne...
  • 3/28/2024 12:00:00 AM

O
Hybrid Care Coordinator - Knoxville, TN
  • Optum
  • Knoxville, TN
  • If you are within a commutable distance of 4315 Kingston Pike, Ste 210, Knoxville, TN, 37919, you will have the flexibil...
  • 3/26/2024 12:00:00 AM

O
Hybrid Care Coordinator - Knoxville, TN
  • Optum
  • Heiskell, TN
  • If you are within a commutable distance of 4315 Kingston Pike, Ste 210, Knoxville, TN, 37919, you will have the flexibil...
  • 3/26/2024 12:00:00 AM

O
Hybrid Care Coordinator - Knoxville, TN
  • Optum
  • Kodak, TN
  • If you are within a commutable distance of 4315 Kingston Pike, Ste 210, Knoxville, TN, 37919, you will have the flexibil...
  • 3/25/2024 12:00:00 AM

O
Hybrid Care Coordinator - Knoxville, TN
  • Optum
  • Maryville, TN
  • If you are within a commutable distance of 4315 Kingston Pike, Ste 210, Knoxville, TN, 37919, you will have the flexibil...
  • 3/25/2024 12:00:00 AM

O
Hybrid Care Coordinator - Knoxville, TN
  • Optum
  • Townsend, TN
  • If you are within a commutable distance of 4315 Kingston Pike, Ste 210, Knoxville, TN, 37919, you will have the flexibil...
  • 3/25/2024 12:00:00 AM

C
RN Care Mgr II
  • Covenant Health
  • Knoxville, TN
  • Overview: Registered Nurse Care Manager, Social Services PRN/OCC, Variable Hours per Pay Period, Day Shift Fort Sanders ...
  • 3/25/2024 12:00:00 AM

Knoxville is a city in the U.S. state of Tennessee, and the county seat of Knox County. The city had an estimated population of 186,239 in 2016 and a population of 178,874 as of the 2010 census, making it the state's third largest city after Nashville and Memphis. Knoxville is the principal city of the Knoxville Metropolitan Statistical Area, which, in 2016, was 868,546, up 0.9 percent, or 7,377 people, from to 2015. The KMSA is, in turn, the central component of the Knoxville-Sevierville-La Follette Combined Statistical Area, which, in 2013, had a population of 1,096,961. First settled in 178...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$45,520 to $78,121
Knoxville, Tennessee area prices
were up 1.3% 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