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Responsible to supervise all phases of accurate billing of primary, secondary, and tertiary claims to Medicare, Medicaid, Commercial, Work Comp, Automotive, and all others, within insurance timely filing limits.
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Familiarity with Medicaid operations and provider contracting. Join the Medicaid Provider Relations team as Provider Relations Manager, where you will act as the primary resource for assigned, high profile providers and groups (i.e. local, individual providers, small groups/systems) to establish, oversee, and maintain positive relationships by assisting with complex issues regarding Medicaid policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs.
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Awareness of NCQA requirements, CMS guidelines, Medicaid/Medicare contracts and benefit systems. 2+ years of clinical experience, primary care, home-based medical care, geriatrics or palliative care of emergency/urgent care.
$40,000Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Sees any insurance, Medicaid, Medicare. Ambulatory, walk-ins, full range, after hospital stay visits. Support staff: 2-3 APP's, MAs, triage nurses, BH consult team. All ages, newborn to death.
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Position has primary responsibility for claims adjudication, claims payment and check processing for all healthcare claims and for assisting providers in troubleshooting claims issues. Maintains HIPAA compliance and identifies potential issues surrounding fraud, waste or abuse of Medicaid funds are appropriately reported to Compliance department.
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5 Common Interview Mistakes
Everyone's interview process is unique in some form or fashion. Like most, your interview process is crafted so you can get the most information out of your candidates to increase hiring confidence and make the right hiring decisions. However, there are often small problems in interview processes that could ultimately affect the success of hiring decisions.
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Glassdoor estimates that, on average, there are about 250 applicants for every job vacancy out there. If you’ve ever applied for a job, the odds are that you’ve received the dreaded job rejection email.
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