Managed Care Specialist
The Community Health Center is a non-profit social service agency in the Akron area providing comprehensive treatment, primary health care, prevention, and housing services for addictive and compulsive behaviors and disorders.
We are currently seeking a Managed Care Specialist to ensure compliance with third-party payer requirements. Responsibilities include, but are not limited to: review claims according to E & M coding standards for accuracy; ensure correct codes are being used as per visit documentation; assist billing with claims review, adjustments, and resubmittal; review paneling requirements for third-party payers; complete staff credentialing with third-party payers; verify payer coverage for clients, determine prior authorization requirements and obtain necessary prior authorizations; and determine third-party payer benefits for clients; foster an environment of exceptional customer service; and follow up on issues to ensure claims and payments are processed and accepted, and rectify in a timely manner.
Must maintain current knowledge of billing and collections requirements. Will work independently under the supervision of the Division Director, with considerable latitude for initiative and independent judgement to make billing processes more efficient and standardized. Should be very knowledgeable in all aspects of medical office operations including billing, coding, and collections.
Minimum Requirements: Must have a high school diploma, Associates or Bachelor’s degree in accounting/finance/business preferred. Must have a minimum of 5 years “hands on” experience in healthcare billing/coding utilizing an electronic healthcare records system. Must have E&M coding and ICD-10 experience. Must be a medical coding and billing professional. One of the following certifications is required: Certified Professional Coder (CPC), Certified Coding Specialist – Physician (CCS-P), Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Associate (CCA) by American Health Information Management Certification (AHIMA). Must have excellent written and verbal communication skills, the ability to multitask, be flexible and able to function well in a fast-paced environment, be extremely efficient and organized and have the ability to manage deadlines, enforce policy, resolve conflict, and the ability to take direction. Must maintain confidentiality and adhere to all HIPAA guidelines/regulations.
The Community Health Center is an Equal Opportunity Employer and Provider of Services.
The Community Health Center is a Non-smoking facility.
Please send resume and include the position for which you would like to apply:
Via e-mail, email@example.com
Via fax, 330-208-2136. Attn: HR Dept
Via mail, Community Health Center / Attn: HR /
838 Coburn St. Akron, Ohio 44311
or visit our website at www.commhealthcenter.org/jobs