Managed Care Coordinator

Carolina Neurosurgy & Spine Associates•Charlotte, NC

23h•Onsite

About The Position

Carolina Neurosurgery and Spine Associates is seeking a Full-time Managed Care Coordinator for our Charlotte office. Job Objective: To maximize practice revenue by working effectively and efficiently with others to meet monthly RCM goals. Promotes positivity and collaboration within all CNSA departments.

Requirements

At least a High School Diploma or GED.
Minimum one year of pre-certification experience in a health care organization
Knowledge of Medical and insurance terminology
Knowledge of Payer guidelines
Knowledge of Legal and ethical considerations related to patient information
Knowledge of HIPAA guidelines and policies
Awareness and understanding of interdepartmental responsibilities for informed decision making
Time management, problem solving, multitasking, and prioritizing
Effective communication
Basic understanding of Microsoft Office Suite and Electronic Medical Record (EMR) systems
Detail orientation
Ability to establish and maintain effective working relationships with coworkers and diverse patient populations
Ability to analyze situations and respond appropriately
Ability to organize and prioritize information and assignments
Ability to work independently with little or no supervision

Nice To Haves

Post-secondary education in any field is desirable.

Responsibilities

Obtains authorization for procedures as applicable to the patient’s insurance in a timely manner and based on urgency
Works denials for unapproved pre-authorizations; follows up with insurance company to verify approval
Works closely with Coding Department to ensure proper codes are authorized
Communicates in an appropriate, professional manner with insurance associates, other CNSA staff, and patients or patient’s family members/contacts
Updates database with authorization and managed care data
Informs manager of critical situations concerning insurance plans
Provides assistance to co-workers/satellite offices with education, problems, and questions concerning insurance and the authorization process
Maintains strictest confidentiality and follows all CNSA guidelines regarding HIPAA regulations
Performs at least minimum number of required tasks as assigned by management
Completes additional tasks as assigned by management
Reflects CNSA Core Values in all job responsibilities and interactions
Reports to work and adheres to assigned schedule from manager
Performs high-quality work that is neat, accurate, complete, and on time
Offers help to all patients by promptly responding to requests and needs
Asks questions to gain full understanding of assignments
Uses computer for approved work purposes only, and limits personal phone calls