For more than 45 years as a multi-specialty, privately-owned practice, Raleigh Medical Group has realized that there is more to quality health care than state-of-the-art medicine. In today’s complex medical environment, our internists like to keep things simple: we focus and prioritize our patients' needs. We tailor our treatments to provide patients with the finest personalized health care available for each stage of their adult life.
We understand that when our team members are taken care of, so are our patients. Each day we strive to support our team, give them the resources needed to grow, and create an enjoyable work environment. Our organization continues to grow, and so does our team! We are looking for a Managed Care Specialist to join our group.
Does this sound like a fit? Check out the details! The Managed Care Specialist is responsible for the processing and completion of managed care referrals, authorizations/pre-certifications for diagnostic testing procedures, specialized office visits, and medications.
We Offer Our Valued Employees

• Group Health, Dental, and Vision
• FSA and HSA options
• Generous Paid Time Off (PTO)
• 401(k) Retirement Plan with matching
• Company provided Short-Term and Long-Term Disability
• Company provided Life Insurance
• Competitive Salaries
• Annual Employee Appreciation Events

On An Average Day, You Will

• Obtains authorizations and pre-certifications for patients if required by their insurance policy for diagnostic procedures, specialized office visits and medications in a timely manner.
• Accurately documents data in the practice management software, and EHR.
• Places telephone calls to patients, insurance companies, referring physicians, and pharmacies.
• Maintains professional and courteous demeanor during all telephone calls, internally and externally.
• Continues to stay current on job responsibilities and any changes/updates provided.
• Attends all departmental meetings and communicates procedure changes with physicians, nurses, and front office personnel.
• Perform tasks in accordance to departmental policies, procedures, and protocols.
• Cross-trains in all functions of the department as requested.
• Assists in the training of new staff in all functions of the department when requested.
• Attends educational seminars/webinars on and off site as necessary to maintain proficiency and secure understanding of updated policies and procedures.

To Qualify For This Job You Must Have

• High school diploma or equivalent.
• One year of medical office experience and EHR experience.
• Medical terminology.
• Customer service concepts and techniques.
• Use of medical office equipment including phone, computer, fax machine, and copier.
• Time management, problem solving, multitasking, organizing, and prioritizing.
• Understanding and following written and oral instruction.
• Maintaining confidentiality of sensitive information.
• Completing work in a timely, accurate, and thorough manner.
• Communicating effectively both verbally and in writing with patients and other individuals inside and outside the practice.
• Exhibiting a professional manner in dealing with care team members and diverse patient populations, and working to maintain constructive working relationships.

Physical Requirements And Work Environment

• Sitting approximately 95% percent of the day.
• Extensive keyboarding and telephone usage.
• Occasional lifting up to 10 pounds.
• Corrected vision and hearing to normal range.
• Fine motor skills.

EEO StatementRaleigh Medical Group is an equal opportunity employer committed to workplace diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, gender identity, protected veterans status, status as a disabled individual, or any other protected group status or non-job characteristic as directed by law.