Risk Management Specialist jobs in Norfolk, NE
Recently Added Risk Management Specialist jobs
Authorization Specialist
- Village Practice Management Company,LLC
-
Center, NE
FULL_TIME
- About Our Company We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care. Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians. When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care. Job Description Position Summary: The Authorization Specialist is responsible for obtaining authorizations for surgical procedures, diagnostic testing, medications, DME, outgoing referrals, and other services as part of the daily operations of the Revenue Cycle Department. Authorization Specialists must have a keen understanding of medical insurance and the clinical policies that determine the authorization protocols for each health plan. Essential Job functions: · Identifies all appointments and procedures for assigned departments that require authorization by monitoring the schedules, system reports, and dashboards · Identifies the referral and authorization requirements of the patients’ insurance plans by using various on-line resources according to department workflows · Demonstrates knowledge of insurance carrier guidelines, clinical policies, and state guidelines pertaining to referrals and prior authorization · Verifies insurance eligibility and benefits, and updates the patient’s insurance information as necessary · Completes referrals and prior authorizations in a timely manner according to department guidelines and workflows · Communicates clearly and effectively with patients, physicians, office staff and manager to resolve issues that may result in a denied or delayed authorization request. · Demonstrates complete system knowledge, ability to run reports, document and manage referrals and authorizations, move correspondence, resolve eligibility and authorization holds, and other system tasks within the user’s security access · Demonstrates the ability to request, prepare, and recognize the documentation required to support the medical necessity for the service being authorized · Provides the supervisor and manager with immediate feedback on issues affecting workflow, reimbursement, and customer service. · Ensures that appropriate and accurate information is entered in the patient account · Responds timely and collaborates effectively with the Reimbursement Department teams to limit denials and ensure proper reimbursement · Collaborates with team members to meet department deadlines and benchmarks · Demonstrates the ability to use the electronic tools and systems available to organize and process the daily work · Anticipates and performs necessary job duties. · Maintains patient confidentiality General Job functions: · Expert in selecting the correct insurance package in Epic. · Updates authorizations and claims to reflect the new insurance package. · Expert in sorting work queues and reports to identify and process the daily work (Manage Schedules - Inbound Referral Report - Outgoing Referrals) · Moves correspondence from the dashboard to the patient’s account. · Expert in generally accepted insurance benefit terms and processes. · Expert in Communication (Case and authorization notation - Physician and Practice location staff – Peers - Supervisor/Manager – Payers) · Expert in requesting and preparation of supporting documentation such as medical records, dictation, and orders. · Expert in investigation of authorization denials and appeals (Insurance – Patient) · Patient Financial Counseling o Work up the out of pocket cost estimate for patient o Search for co-pay assist, free drug or grants that the patient may qualify for o Either call or meet with patient to discuss their options o Will work with the ordering Provider if the patient can still not afford the medication to see if there are other alternatives on the medication that may be cheaper. Education, Certification, Computer and Training Requirements: · High School Graduate/GED Required. · Vocational / Technical School / Diploma Program Preferred · 2-4 years of related experience Preferred · Experience with Standard Office Equipment (Phone, Fax, Copy Machine, Scanner, Email/Voice Mail) Preferred. · Experience Standard Office Technology in a Window based environment & Microsoft Office Suite Required. About Our Commitment Total Rewards at VillageMD Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan. Equal Opportunity Employer Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws. Safety Disclaimer Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/. Join our Talent Network! Click the 'Get Started' button below to create a Candidate Home account to stay up to date on our most recent Job Postings! We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care. Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD and Starling Physicians. When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care. The work we do is changing the lives of our patients, our communities, and each other. Join us as we deliver the care we want to see in the world. Together, we can create better outcomes for all.
- 13 Days Ago
Risk Officer
- Adams, Inc.
-
Norfolk, NE
FULL_TIME
- ACNE68233 – Risk Officer – Norfolk, NE Our client is a community bank that is seeking a Risk Officer for their site in Norfolk, Nebraska. This individual will be responsible for creating a risk manage...
- 1 Day Ago
HOA Management Assistant
- J&M PROPERTY MANAGEMENT
-
Sioux, IA
FULL_TIME
- Job Description: HOA Management Assistant Location: Sioux City, IA, 51101 Skills Required: Organized Meticulous Professional demeanor Public speaking Detail oriented Considerate Compassionate Flexible...
- 1 Month Ago
Management Internship
- Menard, Inc Career Center
-
SIOUX CITY, IA
PART_TIME
- Part-Time Make BIG Money at Menards! Extra $3 per hour on Sat/Sun Store Discount Profit Sharing Exclusive Discounts for gyms, car dealerships, cell phone plans, and more! Flexible Scheduling Dental Pl...
- 1 Day Ago
Management Internship
- Menard, Inc Career Center
-
NORFOLK, NE
PART_TIME
- Part-Time Make BIG Money at Menards! Extra $3 per hour on Weekends Store Discount Profit Sharing Exclusive Discounts for gyms, car dealerships, cell phone plans, and more! Flexible Scheduling Dental P...
- 9 Days Ago
Management Trainee
- Dayton Freight
-
Sioux, IA
FULL_TIME
- Overview Stable and growing organization Fast paced work environment Internal advancement opportunities Competitive weekly pay Modern facilities and technology Unique leadership opportunity Travel Com...
- 11 Days Ago
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0 Risk Management Specialist jobs found in Norfolk, NE area
Planning Analyst
- Vishay Intertechnology, Inc.
-
Columbus, NE
- We are seeking great talent to help us build The DNA of tech.® Vishay manufactures one of the world’s largest portfolios...
- 4/26/2024 12:00:00 AM
Financial Advisor
- Prudential Financial
-
Columbus, NE
- Explore a career as a FINANCIAL PLANNER! Take your career to the next level at Prudential Advisors! Change your life by ...
- 4/26/2024 12:00:00 AM
Financial Services Professional
- Bankers Life
-
Norfolk, NE
- Bankers Life®, one of the most respected brands in the Financial Services industry, is seeking ambitious individuals to ...
- 4/25/2024 12:00:00 AM
Financial Services Professional
- Bankers Life
-
Norfolk, NE
- Bankers Life, one of the most respected brands in the Financial Services industry, is seeking ambitious individuals to g...
- 4/25/2024 12:00:00 AM
Fuel Compliance Officer - 12 Month Register
- Department Of The Treasury
-
Norfolk, NE
- DutiesWHAT IS THE SMALL BUSINESS SELF EMPLOYEDDIVISION?A description of the business units can be found at: https://www....
- 4/24/2024 12:00:00 AM
Financial Advisor
- Prudential Financial
-
Columbus, NE
- Explore a career as a FINANCIAL PLANNER! Take your career to the next level at Prudential Advisors! Change your life by ...
- 4/23/2024 12:00:00 AM
Customer Experience Specialist
- Farm Credit Council
-
Norfolk, NE
- Farm Credit Services of America (FCSAmerica) is a great place to work. You see it in our people and the relationships th...
- 4/22/2024 12:00:00 AM
Internal Revenue Agent (Senior Revenue Agent (Examiner) -12 MONTH ROSTER
- Department Of The Treasury
-
Norfolk, NE
- Duties WHAT IS THE SBSE - SMALL BUSINESS SELF EMPLOYED DIVISION? A description of the business units can be found at: ht...
- 4/22/2024 12:00:00 AM
About Norfolk, Nebraska
Norfolk (/ˈnɔːrfɔːrk/ or /ˈnɔːrfoʊk/) is a city in Madison County, Nebraska, United States, 113 miles northwest of Omaha and 83 miles west of Sioux City at the intersection of U.S. Routes 81 and 275. The population was 24,210 at the 2010 census, making it the ninth-largest city in Nebraska. It is the principal city of the Norfolk Micropolitan Statistical Area.
Norfolk is located at 42°1′42″N 97°26′01″W / 42.02833°N 97.43361°W / 42.02833; -97.43361 (42.0283379, -97.4169964).
According to the United States Census Bureau, the city has a total area of 10.78 square miles (27.92 km2), of which, 1...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Risk Management Specialist jobs
$90,784 to $112,642
Norfolk, Nebraska area prices
were up 0.8% from a year ago
were up 0.8% from a year ago
What does a Risk Management Specialist do?
Risk Management Specialist
Demonstrate the ability to identify changes to Credit Union processes, procedures, or regulatory requirements that will impact the duties of the department and proactively recommend updates to departmental processes and procedures to adapt to Credit Union changes in a timely manner.
November 08, 2022
Assists in the maintenance, integrity and data quality of the franchisee insurance certificate tracking program, including database management, as well as communication with franchisees, Area Directors and other internal stakeholders relative to insurance compliance.
March 09, 2023
Assist with the validation of financial and compliance models utilized by the Credit Union based on regulatory guidelines, which may include assessing model documentation, model objectives and use, model data, outcome analysis, ongoing monitoring, governance, and backtesting.
March 29, 2023
Provides recommendations for improvements to the business continuity/disaster recovery program and works with business units to implement approved changes to the business continuity/disaster recovery program process.
April 21, 2023
Participates in the identification, selection, & coordination of the use of TPA's and consultants for property damage claims, subrogation, workers compensation & general liability claims adjudication.
April 30, 2023
Review and challenge of Banking business liquidity, interest rate and capital risk exposures through both ad-hoc and routine engagement within Risk, CFO and the LOB teams (including Risk Identification, State of Risk Reviews, and resulting SIAI/RIAI administration).
May 07, 2023