FEATURED JOBS
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…working knowledge of hospital operations, utilization management, case management, and managed care reimbursement, preferred. + General understanding of revenue
…pertinent to patient service and billing procedures: including basic knowledge of all managed care plans and which insurers require a copayment or referral.
…state of practice. + Three years clinical nursing experience. + One year in Managed Care , Utilization Management, or Case Management. + Basic computer skills
…Coordinators in the Berks County area! Community HealthChoices (CHC) is Pennsylvania's managed care long-term services and supports (LTSS) program serving
…and PAs (within the last 3 years) or 1 year of recent experience in Pharmacy Managed Care (within the last 3 years) isrequired. + Demonstrated knowledge of the
…+ A minimum of two (2) years quality/utilization review experience in an HMO, managed care organization, or similar experience as a hospital inpatient coder or
…case management, including finding psychiatric beds and obtaining authorization from managed care companies. Works in close collaboration with on-call
Billing and Follow Up Representative-II (Hospital Medical Claims Follow-up) - PFS (Remote)
Trinity Health
…and systems working within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service
…and supports them in performance of job duties. Is familiar with managed care contracts, expected reimbursements and billing and collection practices.
…+ Maintains statistics related to Intake Services. + Provides clinical reviews for managed care organizations when not involved with EC responsibilities. +