Managed Care Coordinator

The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insurance benefit information to patients and patient care departments. The Managed Care Coordinator assists patients and providers with developing strategies for alternative options for non-covered services by communicating with the provider, patient, insurance carrier and Patient Assistance Counselor.

JOB QUALIFICATIONS

EDUCATION

For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation.

Minimum Required: High school diploma or equivalent. Successful completion of a medical terminology and an anatomy & physiology course, per departmental procedures, within one year of hire.

Preferred/Optional: Successful completion of a medical terminology and an anatomy & physiology course at time of hire. Graduate of a Medical Assistant, Health Unit Coordinator or Health Care Business Service program.

EXPERIENCE

Minimum Required: Two years’ experience in a medical business office or health care setting. Prior experience should include working with and obtaining insurance eligibility and benefit information.

Preferred/Optional: None

CERTIFICATIONS/LICENSES

The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position.

Minimum Required: Basic Life Support (BLS) certification awarded by the American Heart Association (AHA) within 90 days of hire.

Preferred/Optional: Basic Life Support (BLS) certification awarded by the American Heart Association (AHA) at time of hire. Bilingual Spanish speaking with ability to pass a skills-based assessment proving ability to interpret.

Equal Employment Opportunity