Managed Care Coordinator

2 weeks ago

Miami, United States North Coast Medical Supply LLC Full time
About Our Company

Advanced Diabetes Supply® was founded on the bold principle of creating a knowledgeable, reliable and demonstrably superior diabetes supply company. Our approach, coupled with a commitment to service and innovation, has catapulted Advanced Diabetes Supply® to a national leader in the industry. Creating high-performance, adaptive teams requires a relentless commitment to hiring the best. We strive to maintain a casual, fun environment whenever possible, but we don't just play around. We work hard every day to provide a positive work culture and respectful atmosphere. The standards we set for ourselves are high, and we love to be challenged If you enjoy working in a collaborative environment, have a passion for excellence and a bias for action, we may be just what you've been looking for.

Interested in learning more about our company and its culture? Visit us at www.northcoastmed.com

About The Position

Hours: 8:30 AM to 5:00 PM ET, Monday to Friday

Location: Remote

Position Summary

The Managed Care Coordinator is responsible for accurate Durable Medical Equipment credentialing with various Managed Care and Medicaid State insurance plans and identifying, developing, and establishing strategic relationships with assigned managed care payors. The Managed Care Coordinator will work within the scope of responsibilities as dictated below with guidance and support from our Sales Operations leadership team.

Essential Functions
  • Identifies opportunities to enter closed networks and negotiates existing contracts by selling the NCMS value and scheduling meetings for executive leadership to present to targeted managed care payors.
  • Maintains a thorough knowledge of reimbursement methodologies, contractual terms, billing and other operational factors needed for contracting and contract implementation.
  • Verifies enrollment status for all Managed Care plans including contracted Medicaid states to ensure proper and timely billing.
  • Communicates with providers and others in the organization to obtain necessary documentation for application/contract submissions.
  • Negotiates reimbursement rates in order to increase the percentage being offered for all lines of business.
  • Conducts active outreach to plans to follow up on applications/contracts submitted; verifies NCMS information in the New Business Database to ensure we have an active provider number.
  • Adapts quickly to frequent process changes and improvements.
  • Is reliable, engaged, and provides feedback as to improve processes and policies.
  • Attends all department, team, and company meetings as required.
  • Embraces and exemplifies ADS core values:
  • We grow together
  • We care
  • We obsess over the customer experience
  • We commit
  • We WOW
Other Responsibilities
  • May perform any additional responsibilities or special projects as required.
  • Duties and responsibilities may be subject to change based upon the needs of the department.
Requirements
  • High School diploma or equivalent
  • Demonstrated success in meeting goals and objectives
  • Minimum 6 months' sales experience
  • Experience with managed care payors desirable
  • Basic knowledge of DME and/or pharmacy operations desirable
  • Proficiency in basic math and business calculations
  • Working knowledge of computer/data entry with the ability to learn new systems
  • Basic level of MS Office proficiency
Expected Competencies
  • Professional verbal and written communication skills, including interpersonal skills with a demonstrated ability to collaborate with a team
  • Effective, professional, and engaging communication and presentation skills
  • Strong organizational and time management abilities; proven ability to meet deadlines within time and resource constraints
  • Service-orientation and aptitude to effectively resolve problems
  • Clear diction and knowledge of the English language, both written and verbal
  • Self-directed accountability and reliability
  • Cultural competence
Physical Demands

The physical demands described below are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable employees with disabilities to perform the essential functions.

While performing the responsibilities of the job, the employee is required to remain in a stationary position most of the time (stand or sit). While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is frequently required to stand, walk and reach with hands and arms. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.

Other Requirements
  • Candidates must successfully pass a background check.
  • Candidates must be able to provide proof of eligibility to work in the United States without support; sponsorship is not available.
Pay Range and Compensation Package

Pay ranges may vary depending on location. Actual compensation depends on education, experience, and relevant skills.

Benefits for full-time employees include:
  • Health, Dental & Vision options
  • FSA and HSA plan with Employer Contribution
  • Employer paid EAP
  • 401k with 4% Company Match
  • Paid Time Off (PTO) Including 7 Paid Holidays and a Birthday Holiday
  • On-Site Gym
  • In-house Training Programs
  • A fun culture in a fast-growing organization

Equal Opportunity Statement

Advanced Diabetes Supply® provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type based on race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

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