Managed Care Supervisor jobs in Newhall, CA

Overview:

Ethos Management, Inc provides Collections, Billing, Accounts Receivable and Customer Service support to AHMC Hospitals to assist with their revenue cycle objectives.

The Managed Care Collector position is responsible for the reimbursement of claims from various insurance companies.

A SUCCESSFUL CANDIDATE MUST HAVE:

• Minimum 1 year of recent hospital or physician’s collections experience.
• Understanding of managed care payor contracts and contract language.
• Working knowledge of Microsoft Excel at a proficient level.
• Insurance terminology essentials.
• Firsthand knowledge of current regulatory requirements to ensure prompt and accurate reimbursements.
• Ability to determine if a claim is underpaid for appeals submissions.

Major Responsibilities/Activities:

• Proactively calls and provides follow-up with insurance companies to expedite payments.
• Responsible for assigning accounts and meeting department’s productivity expectations.
• Monitors and/or follows-up on accounts by using insurance company’s web-portal and/or make telephone calls to assure timely resolution and accurate reimbursement.
• Contacts insurance companies to inquire about claim denials and ensures proper resolution is applied.
• Monitors and/or follows-up on accounts.
• Effectively uses contact knowledge and ‘Affiliated Medical Group Matrix’ to determine ‘grey’ area contract language.
• Utilizes aging reports to monitor each account and resolve barriers to assure timely and correct payments
• Maintains proper follow-up on commercial accounts using department's collection guidelines, policies and procedures.
• Uses, protects, and discloses patients’ protected health information only in accordance with Health Insurance Privacy and Portability Act (HIPAA) standards.

* Ethos Management is an Equal Employment Opportunity Employer.

Job Type: Full-time

Pay: $21.00 - $27.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Physical setting:

• Office

Schedule:

• 8 hour shift

Experience:

• Handling Managed Care Payor Contracts: 1 year (Required)
• Working with Insurance Contractual Language: 1 year (Required)
• Hospital or Physicians Collections: 1 year (Required)
• Following up with Insurance Companies for Payment: 1 year (Required)
• Submitting Appeals to Insurance Companies: 1 year (Required)

Work Location: In person