Managed Care Coordinator

Carolina Neurosurgy & Spine Associates•Charlotte, NC

4d•Onsite

About The Position

Carolina Neurosurgery and Spine Associates is seeking a PRN Managed Care Coordinator for our Charlotte office. The primary objective of this role is to maximize practice revenue by working effectively and efficiently with others to meet monthly Revenue Cycle Management (RCM) goals. The coordinator will promote 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.
Skills in Time management, problem solving, multitasking, and prioritizing.
Effective communication skills.
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.
Participates in department or system wide improvement plans.
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.