What are the responsibilities and job description for the Managed Care Coordinator position at MERAKEY?
Position Details
- Interact with physicians, Merakey staff (Nurses, Adaptive Equipment Specialist, Motor Development Specialist, PT, OT, ST, Administrators, etc.), 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, Merakey Fiscal Department and family contacts, as needed, to obtain resolution.
- Maintain current client insurance information by working with Social Services, Fiscal Dept. and family contacts.
- Establish and maintain various file systems, as directed.
- Travel to various Merakey facilities to consult with the physician and Merakey staff to retrieve information from charts, as needed.
- Attend 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.
- Assist in reconciliation and tracking of Warehouse orders/deliveries and assist in resolving any discrepancies.
- Perform related duties, special assignments and projects as required
Benefits
Merakey offers Flexible schedules, Medical, Dental, Vision insurance plans, competitive compensation plans, Work/Life balance, and so much more!
ABOUT MERAKEY
Merakey is a leading developmental, behavioral health, and education non-profit provider with a fifty-year history. We offer a breadth of integrated services to individuals and communities across the country. Our belief that every individual has the right to achieve growth, dignity, and fulfillment guides all of our decisions. At Merakey, we care about each other and are committed to providing the very best care to those we serve.
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.
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
- Care.com 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. Click here to watch a video about Merakey. 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!
