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Carrot Peelers, Sales, Personality and Your Job Search
In-House
Legal Staff
Corporate - Contract Law
Finance - General
Min 1 yrs required
Managed Care Contracting and Reimbursement Specialist The candidate will be completing and submitting applications for provider agreements. Will be abstracting provider agreements to summarize terms, plan descriptions and fee schedules for attorney review. Handling renewals, re-credentialing and amendments for existing provider agreements. Organizing commercial and governmental contracts electronically. Preparing written reports on the status of participating managed care provider agreements and the provider agreements requested to obtain. Monitoring reimbursement for accuracy and timeliness. Identifying and reporting on types of claims denied and making recommendations to improve reimbursement. Researching and formulating grounds to appeal claim denials. Transmitting required documentation to government or commercial payers to resolve payment issues. Staying current on payer policies by accessing and navigating the portals. Must have High School Diploma, Associates or College Degree. Paralegal certification is a plus. Must have 1+ year of accounting, reimbursement, finance and/or accounts receivable experience with knowledge of payment posting, claims, remittances, insurance follow-up and reconciliation and billing processes. Must have excellent written and verbal skills. Should be proficient in the use of a personal computer, Excel and Word.
Requisition Number 18-0133.
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