Precertification Specialist, Managed Care Experience Preferred

CommuniCare • Indianapolis, IN

2d • Onsite

About The Position

The Pre-certification Specialist assists in developing census and providing external and internal support throughout the admissions process. Previous experience required; Managed Care experience preferred. This position must work flexible hours. This is not a sales position and the workplace is in an office setting - not in a nursing home. Monday - Friday - Day Shift (full time) Wednesday 12pm-8pm on call for pre cert remotely from home Every 4th weekend -on call for pre cert remotely from home At CommuniCare, you will enjoy competitive wages, commensurate with experience, and PTO plans. We offer you a menu of benefit options from life and disability plans to medical, dental and vision coverage, from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts.

Requirements

• Previous admissions experience required; Managed Care Precertification experience preferred.
• Must have knowledge of Medicaid, Medicare, and Managed Care procedures, as well as laws, regulations, and guidelines that pertain to skilled nursing.
• Knowledge of Corporate Business Management
• This position must work flexible hours
• Ability to work independently and as a team
• Superior customer service skills, including the ability to resolve conflict
• Good organization skills
• Ability to communicate effectively verbally and in writing
• Must be respectful and a team player
• Must maintain a professional appearance and demeanor
• Must maintain a high level of confidentiality in all aspects of the job
• Must be able to deal tactfully with team members, other staff, residents, and family members, visitors, government agencies, and the general public.
• Must have the ability to make independent decisions when circumstances warrant such action.
• Must be skilled at multitasking and have a sense of urgency to perform time sensitive processes.
• Must possess basic computer skills.

Nice To Haves

• Managed Care experience preferred.

Responsibilities

• Perform all pre-certification processes for Admission.
• Establish and maintain a positive and professional relationship with current and potential Managed Care providers and work to ensure patient and provider satisfaction.
• Communicate with Interdisciplinary team daily to process managed care referrals for precertification approval.
• Organize and maintain documentation of clinical records for submission to managed care organizations.
• Maintain up-to-date financial knowledge of skilled operations, managed care contracts and provide accurate documentation of all services in order to assure accurate reimbursement from all payor sources.
• Demonstrate excellent communications, negotiation, and public relations skills.
• Demonstrate autonomy, organization, assertiveness, flexibility, and cooperation in performing job responsibilities.

Benefits

• competitive wages, commensurate with experience, and PTO plans
• life and disability plans to medical, dental and vision coverage, from quality benefit carriers
• 401(k) with employer match
• Flexible Spending Accounts

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed