Top Managed Care Executive jobs in Tampa, FL

: MANAGED CARE BILLING SPECIALIST

• Perform initial audit on all charts within 24hours of QA approval

• To follow up on and/or correct any issues found upon initial review in a timely manner

• Run a daily discharge report to identify new discharge patients

• Perform an EOE (final claim audit) on all discharged patients and patients who reached the end of their episode and will be continued within 48 hours

• Update managed care billing spreadsheet daily with new discharges/items needed

• Send e-mail weekly to all staff involved in resolving issues holding up final billing

• Follow up with medical records, clinicians, QA, etc. to get tasks completed needed for billing on a daily basis

• Run a daily “orders returned” report to identify signed orders/evals

• To follow up on and/or correct any issues found upon final claim audit timely

• Responsible for filing all managed care claims as directed by Billing Manager daily

• Follow up on all denied/rejected managed care claims in a timely manner

• Posting of managed care payments in Wellsky on a daily basis

• Export of all managed care Oasis Assessments to State on a weekly basis

• Follow up/inform Billing Manager of any issues stemming from Oasis Validation Reports same day

• Partial training performing managed care eligibility checks/requesting auth / entering authorizations, in order to function as back up as needed

• Keep Billing Manager informed on a daily basis of any issues/concerns related to any managed care charts/billing issues/oasis issues etc.

REQUIRED SKILLS:

• Exceptional follow up skills

• Organized

• Detail oriented

• Able to multi-task

• Able to work without supervision

• Able to communicate well with authorization department and health plans

• Ability to work well under pressure