RESPONSIBILITIES:

• Responsible for direct communication and building relationship contacts with health plans to secure Single Case Agreements.
• Responsible for the management of all Single Case Agreements, including, tracking outcomes, identifying problem payers, negotiating rates (as needed), and securing required signatures.
• Oversees and ensures the accuracy of Single Case Agreements meets authorization and claims requirements.
• Collaborate with Provider Relations Manager, Verification of Benefits Manager and Revenue Cycle manager on payment analysis and providing feedback for new patient admissions and or continuation of care.
• Present feedback on outcomes and correspondence or lack of correspondence related to Single Case Agreements that present risk on reimbursement outcomes.
• Routinely evaluates Insurance Master, Plan Guidelines and non-contracted tools of current processes and make updates as needed based on Single Case Agreement outcomes.
• Acquires necessary medical records and documentation from customer charts to communicate via phone, fax or e-mail with other medical facilities, hospitals and insurance carriers.
• Follows all regulatory policies and procedures, privacy and security standards in accordance with government agencies to include HIPAA requirements.
• Performs other duties as assigned by superiors

BASIC QUALIFICATIONS | EDUCATION:

• Three to Five (3-5) years’ experience in insurance benefit verification and/or collections and/or managed care contracting.
• Understand the process for verification of benefits and collections as it relates to the policies and procedures for effective placement of customers and reimbursement.
• Complete Understanding of Medicare Rules and Regulations
• Advanced MS Office experience, with an emphasis on MS Excel desired
• Continued Self Improvement courses & seminars related to position along with “In House” programs provided by Acelis Connected Health/Abbott.

PREFERRED QUALIFICATIONS:

• Knowledge in Managed Care
• Knowledge in Contracting and Negotiations
• Strong Verbal and Written Communication Skills
• Strong Computer/Software Skills

COMPETENCIES:

• Problem Analysis to identify Interests and Goals
• Negotiating skills
• Decision Making Ability
• Active Listening skills
• Clear and Effective Communication
• Maintaining Good Relationships/Collaboration
• Ethics and Reliability
• Detail Oriented
• Organization/Time Management Skills

EXPLORE LOCATION