Managed Care Coordinator jobs in Pennsylvania

External Description

Interface with physicians, AVS staff (Nurses, Adaptive Equipment Specialist, Motor Development Specialist, PT, OT, ST, & Administrators), Durable Medical Equipment vendors, pharmacy, etc.

to obtain documentation, facilitate billing and coordinate follow-up.

• Communicate with family regarding insurance questions, issues, changes, etc.
• Complete, submit and track all letters of medical necessity, medical exceptions and other documentation, resubmissions, approvals, rejections and billing for physical / medical consults, therapies, durable medical equipment / supplies, and other services needed by the individuals and paid for by insurances.
• Coordinate referrals for physician, therapy services, testing and DME needs.
• Coordinate the appeals process on behalf of the physician, as needed.
• Contact area physicians and needed medical services to find those participating in the network.
• Respond to billing inquiries and work with providers, Fiscal, and family contacts, as needed, to obtain resolution.
• Maintain current client insurance information by working with Social Services, Fiscal, and family contacts.
• Establish and maintain various file systems, as directed.
• Travel to various AVS facilities to consult with the physician and AVS staff to retrieve information from charts, as needed.
• Attending Managed Care related meetings which minimally includes House Manager, Pharmacy and Therapeutics, Pre-admission, as well as regular meetings with the Health Services Supervisors to discuss any outstanding issues.
• Respond to insurance inquiries and provides required information and documentation.
• Perform related duties, special assignments, and projects, as required.

Earn between $ -

Benefits

Merakey offers medical, dental - vision insurance plans, competitive compensation plans and more!

• DailyPay
• Work / Life Balance
• Flexible Schedules
• Cell Phone Discount Plans
• Employee Referral Bonuses
• Tuition Reimbursement
• Membership

About Merakey

Merakey is a non-profit provider of developmental, behavioral health, and education services. More than 8,000 employees provide support to nearly 40,000 individuals and families throughout 12 states across the country each year.

Merakey strictly follows a zero-tolerance policy for abuse.

Merakey is proud to be an Equal Opportunity Employer! We deeply value diversity and do not discriminate on the basis of race, religion, color, national origin, ethnic background, sex, gender, gender identity, sexual orientation, age, marital status, veteran status, genetic information, or disability status.

Moreover, we are committed to creating teams that reflect the diversity of the communities we serve and encourage applicants from underrepresented backgrounds to apply.

Merakey welcomes all Veterans to apply!

Requirements

Must be familiar with the managed care field, computer literate or able to learn Microsoft Office.

Last updated : 2024-05-31