Managed Care Coordinator jobs in Ohio

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 Biller
  • CommuniCare Family of Companies
  • Blue, OH FULL_TIME
  • Managed Care Biller

    Due to Company growth, CommuniCare Health Services is currently recruiting a Managed Care Biller for our Corporate Managed Care Billing Department.

    PURPOSE/BELIEF STATEMENT

    The position of Managed Care Biller/Collector is responsible for billing, receivables auditing, and collections activities for services provided to patients in the facilities assigned. Ultimately they are responsible for hitting their cash collection goals each month and minimizing the impact of Bad Debt for the buildings/facilities assigned to them.

    WHAT WE OFFER

    All CommuniCare employees enjoy competitive wages and PTO (Paid Time Off) plans. We offer full time employees a menu of benefit options that include:

    • Life Insurance and Disability Plans
    • Medical, dental, and vision coverage from quality benefit carriers
    • 401K with employer match
    • Flexible Spending Accounts

    POSITION REQUIREMENTS

    • Knowledge of medical billing/collection practices.
    • 3-5 years experience in managed care billing preferred
    • Experience billing various Managed Care companies and understanding the requirements for each payor
    • Claim appeal/resolution expertise preferred
    • Must have a high degree of attention to detail.
    • Strong verbal and written skills required in order to interact with insurance companies to resolve unpaid claims via telephone and written correspondence.
    • Basic computer literacy and skills.
    • Strong organizational skills a must.

    About Us

    A family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients, and family members care for and about one another.

  • 19 Days Ago

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Managed Care Biller
  • CommuniCare Family of Companies
  • Cincinnati, OH FULL_TIME
  • Managed Care BillerDue to Company growth, CommuniCare Health Services is currently recruiting a Managed Care Biller for our Corporate Managed Care Billing Department.PURPOSE/BELIEF STATEMENTThe positi...
  • 7 Days Ago

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Toledo, OH 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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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Columbus, OH 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 Nurse
  • Western & Southern Financial Group
  • CINCINNATI, OH FULL_TIME
  • Overview Summary of Responsibilities: Provides concurrent and retrospective utilization reviews, large case management, disability case management and other programs to improve the quality of medical ...
  • 26 Days Ago

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Managed Care Nurse Staff
  • Western & Southern Financial Group
  • CINCINNATI, OH FULL_TIME
  • Overview Summary of Responsibilities: Provides concurrent and retrospective utilization reviews, large case management, disability case management and other programs to improve the quality of medical ...
  • 1 Month Ago

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Manager Care Coordination
  • Crouse Hospital
  • Syracuse, NY
  • Care Coordination is a collaborative practice model including the multidisciplinary health care team, the patient and fa...
  • 3/29/2024 12:00:00 AM

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Manager Care Coordination
  • Catholic Health Services
  • West Islip, NY
  • Overview Manager of Care Coordination (MCC) - Registered Nurse (RN) Are you exceedingly driven, dedicated, and passionat...
  • 3/29/2024 12:00:00 AM

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Manager Care Coordination
  • St. Catherine of Siena
  • West Islip, NY
  • Overview Manager of Care Coordination (MCC) - Registered Nurse (RN) Are you exceedingly driven, dedicated, and passionat...
  • 3/29/2024 12:00:00 AM

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Managed Care Coordinator - Referrals
  • Beth Israel Lahey Health
  • Boston, MA
  • When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Job Typ...
  • 3/28/2024 12:00:00 AM

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Manager-Care Coordination
  • St. Catherine of Siena
  • Rockville Centre, NY
  • Overview Manager, Care Coordination (RN), Rockville Centre, NY Explore a career with Mercy Hospital, a 375-bed not-for-p...
  • 3/26/2024 12:00:00 AM

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Managed Care Coordinator
  • MJHS Health System
  • New York, NY
  • Req #: 1509 Job ID: 13084 Job Location(s): New York, NY Zip Code: 10040 Category: Office and Administrative Support Agen...
  • 3/26/2024 12:00:00 AM

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Manager, Care Coordination
  • SCAN
  • Long Beach, CA
  • About SCAN SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adult...
  • 3/26/2024 12:00:00 AM

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Case Manager (Care Coordinator)
  • Pacifica Hospital of the Valley
  • Los Angeles, CA
  • Job Description Job Description CARE COORDINTOR (CASE MANAGER) BEHAVIORAL HEALTH URGENT CARE CENTER (OUTPATIENT CLINIC) ...
  • 3/26/2024 12:00:00 AM

Ohio /oʊˈhaɪoʊ/ (listen) is a Midwestern state in the Great Lakes region of the United States. Of the fifty states, it is the 34th largest by area, the seventh most populous, and the tenth most densely populated. The state's capital and largest city is Columbus. The state takes its name from the Ohio River, whose name in turn originated from the Seneca word ohiːyo', meaning "good river", "great river" or "large creek". Partitioned from the Northwest Territory, Ohio was the 17th state admitted to the Union on March 1, 1803, and the first under the Northwest Ordinance. Ohio is historically know...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$48,659 to $83,509

Managed Care Coordinator in New Orleans, LA
Health systems must meet the operational challenge of managing provider data for thousands of participating providers in their value-based care networks.
January 11, 2020
Managed Care Coordinator in Gainesville, FL
Many telehealth programs give patients easy access to any additional educational materials provided by their health plan or primary care provider.
December 23, 2019
Managed Care Coordinator in Houston, TX
Works with relevant parties to ensure deliverable from all parties are achieved in accordance with strategic timelines.Maintains CHSLI master list of service locations (facility, professional and continuing care)Assists in the resolution of referral, authorization and claims payment issuesSupports Directors in effort to educate and assist Hospital departments in meeting internal and MCO operational requirements.
December 27, 2019