Managed Care Coordinator
4 weeks ago
At Orthopaedic Solutions Management, we are seeking a highly organized and detail-oriented Managed Care Coordinator to join our team. In this role, you will be responsible for assisting the Managed Care Coordinators and Manager of the department, as well as acting as the department liaison for credentialing and claim denial related matters.
Key Responsibilities:
- Facilitate and complete Payor roster requests from various payors.
- Manage provider participation status in Athena.
- Manage provider enrollment table in Athena.
- Complete Provider Directory requests from Payors.
- Complete CAQH Attestations for all providers.
- Update the various Managed Care Spreadsheets with pertinent information such as effective dates and provider numbers.
- Send out communications to various departments with provider/payor updates.
- Complete county and city occupational licenses for new providers/offices as well as renewals.
- Process NICA dues annually.
- Complete check requests.
- Perform monthly audit for expirables.
- Provide support to Credentialing Coordinators.
- Responsible for monitoring department inbox.
- Responsible for balancing department credit card and receipts.
- Work with Insurance reps on denial/credentialing issues forwarded from the business office.
- All other duties as assigned.
About You:
- Strong organizational skills.
- Strong interpersonal skills, ability to work across divisions.
- Possess ability to be discreet, as job requires handling of highly confidential information.
- Ability to communicate in a professional manner with physicians, regulatory agencies, as well as all levels of management.
- Proficient in Microsoft Word and Excel.
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