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Managed Care Coordinator

1 month ago

Munster, United States Franciscan Health Full time

Hammond Clinic7905 Calumet Avenue Munster, Indiana 46321WHO WE AREWith 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.WHAT YOU CAN EXPECT Customer Experience Provide customer service experience for patients, providers and health plans.Claims Load, verify and maintain health plan eligibility file in claims system and assign primary care physicians to members.Correspondence Responsible for all correspondence being sent to the member on a monthly basis.EOB Perform weekly check and EOB runs in the claims system and export data to accounting department as well as generating refund requests to providers.Appeals Process claim appeals from patients and providersMail Process all incoming mail and distribute to appropriate staff members.QualificationsPreferred Bachelor's DegreeRequired High School Diploma/GED2 years Health and Managed Care Administration PreferredKnowledge of medical insurance and/or state regulatory requirements preferred. PreferredTRAVEL IS REQUIRED:Never or RarelyEQUAL OPPORTUNITY EMPLOYERIt is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.Franciscan Alliance is committed to equal employment opportunity.

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