Managed Care Coordinator coordinates utilization reviews of managed care contracts using established guidelines and processes. Ensures all clinical operations comply with Medicare and Medicaid guidelines and other managed care policies. Being a Managed Care Coordinator communicates with physicians, discharge planners and others to process referrals, authorization for services, and capture data related to utilization. Maintains managed care contracts and information databases and prepares reports. Additionally, Managed Care Coordinator typically requires an associate degree in nursing. Typically reports to a supervisor or manager. Typically requires Registered Nurse (RN). The Managed Care Coordinator has gained full proficiency in a broad range of activities related to the job. Independently performs a wide range of complex duties under general guidance from supervisors. To be a Managed Care Coordinator typically requires 5-7 years of related experience. (Copyright 2024 Salary.com)
Seeking experienced Certified Professional Coder (CPC). Our ideal candidate will have experience with NYS and/or NJ fee schedule, writing affidavits, and
auditing Hospital, Facility, and surgical bills including Diagnostic Related Groups (DRGs) and Enhanced Ambulatory Patient Groups (EAPGs) bills under Auto/No Fault and Workers Compensation insurance industries. May have to testify in relation to an audit or affidavit they have written.
Great opportunity for growth! We are seeking driven, growth minded professionals who desire an opportunity to grow with the company. Whether you desire to be an expert in your field, or seeking a management position, we are committed to help you achieve your goals.
Managed Care Network, Inc. strives to be the best employer by living our values and by providing a work environment that employees can THRIVE. Through our company values, we support each other to achieve success. We are a company that will appreciate you for the expertise, hard work, and passion you bring to the company.
We offer a great benefits package as well as the flexibility to work remote / hybrid available.
Education & Experience:
· Certified Professional Coder (CPC) Certification
· Comprehensive Knowledge of International Classification of Diseases (ICD-10)
· Must have experience with NYS and/or NJ Fee Schedule
· Must have experience in writing Affidavits/ Affirmations
License/Certification:
· Certified Professional Coder (CPC)
Our compensation includes:
Pay: $55,000.00 - $100,000.00 per year-Compensation based on experience
Job Type: Full-time
Benefits:
Schedule:
Experience:
Work Location: Remote
Job Type: Full-time
Pay: $55,000.00 - $100,000.00 per year
Benefits:
Schedule:
Experience:
License/Certification:
Work Location: Hybrid remote in Niagara Falls, NY 14303
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