Regional Medicare and Managed Care Specialist
Regional Medicare and Managed Care Specialist
The primary purpose of this position is to assist all CT iCare managed facilities with Medicare and Managed Care collections and provide guidance, direction and leadership to all on-site facility business office staff.
Responsibilities:
Monthly tracking of facility Medicare, Managed Medicare, Insurance and Part B claims to ensure billed timely
Provide assistance/completing corrected claims for Medicare, Managed Medicare and Insurance claims
Provide assistance/completing reconsiderations and appeals for Medicare, Managed Medicare and Insurance claims
Monthly review of Medicare, Managed Medicare and Insurance aging reports to review for payment issues and trends
Provide assistance/completing Medicare Secondary Payer claims
Optum A informational claims for all Optum contract buildings
Reviewing DDE for kickback claims that are not corrected timely
Third Eye physician billing for TAB & TAM
Vaccine billing for all facilities - influenza, covid and pneumonia
Assisting with month end close as needed
Assisting with census coverage as needed
Assisting with month end triple check as needed
Maintaining insurance website login’s for Business Office
Training/retraining Business Office staff on correct billing procedures
Qualifications:
Working knowledge of various software programs, required.
Must have experience in long term care business office functions.
Knowledge of Medicare billing procedures, required.
At least 5 years experience in Managed Care billing.
Bachelors in Accounting, Finance or related area, preferred.
Must be highly organized with strong verbal and written communication skills.
Compensation & Benefits
Salary starting at $80,000, commensurate with experience
Occasional hybrid work opportunities
Benefits program, includes health, dental, and vision insurance
Paid Time Off, including vacation, personal, and sick time
401(k) Retirement program
Short and Long-term disability insurance
Collaborative work environment
INDLP