Managed Care Coordinator jobs in Tampa, 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
  • 3 Days Ago

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Managed Care Contract Liaison- Managed Care
  • Lakeland Regional Health
  • Lakeland, FL FULL_TIME
  • Position Information Work Type: Active - Benefit Eligible and Accrues Time Off Exempt: No Work Schedule: Monday - Friday Work Hours per Biweekly Pay Period: Shift Time: Location: 210 Office Building, ...
  • 13 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 Day 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...
  • 29 Days Ago

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Managed Care Contract Manager
  • Shriners Children's
  • Tampa, FL FULL_TIME
  • 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...
  • Just Posted

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Patient Care Coordinator PT - North
  • CRUCIAL CARE
  • Tampa, FL FULL_TIME
  • About Us Crucial Care and GuideWell Emergency Doctor Clinics are free-standing outpatient facilities, providing easy access unscheduled care. Board Certified Emergency Medicine Physicians provide care...
  • 2 Days Ago

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0 Managed Care Coordinator jobs found in Tampa, FL area

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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....
  • 4/19/2024 12:00:00 AM

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Remote Review Family Care Coordinator 1
  • LifeLink
  • Tampa, FL
  • We Are LifeLink... Our Vision is to maximize the gift of life while giving hope to donor families and transplant patient...
  • 4/19/2024 12:00:00 AM

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Patient Care Coordinator
  • Marguerite P Barnett MD PA
  • Sarasota, FL
  • Job Description Job Description Patient coordinator needed for busy plastic surgeons’ office. This position is responsib...
  • 4/18/2024 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...
  • 4/18/2024 12:00:00 AM

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Clinical - Long Term Care Coordinator 1
  • Axelon Services Corporation
  • Tampa, FL
  • Location Requirements: Candidate must reside in Ft. Myers/Lee county. 80%. This position is member facing in members hom...
  • 4/18/2024 12:00:00 AM

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Clinical - Long Term Care Coordinator 1
  • Axelon Services Corporation
  • Tampa, FL
  • Location Requirements: Candidate must reside in Ft. Myers/Lee county. 80%. This position is member facing in members hom...
  • 4/18/2024 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...
  • 4/17/2024 12:00:00 AM

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RN, Care Coordinator-Float Team
  • Chapters Health System
  • Hudson, 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...
  • 4/17/2024 12:00:00 AM

Tampa is a major city in, and the county seat of, Hillsborough County, Florida, United States. It is on the west coast of Florida on Tampa Bay, near the Gulf of Mexico, and is the largest city in the Tampa Bay Area. The bay's port is the largest in the state, near downtown's Channel District. Bayshore Boulevard runs along the bay, and is east of the historic Hyde Park neighborhood. Today, Tampa is part of the metropolitan area most commonly referred to as the "Tampa Bay Area". For U.S. Census purposes, Tampa is part of the Tampa-St. Petersburg-Clearwater, Florida Metropolitan Statistical Area....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$46,699 to $80,142
Tampa, 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