FEATURED JOBS
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Customer Service Representative - Revenue Cycle Consumer Center - Day Shift - Full Time
Sharp HealthCare
…Start Time** **Shift End Time** HS Diploma or Equivalent; Certified Specialist Managed Care (CSMC) - Healthcare Financial Management Association; Certified
…License: CA RN, LVN/LPT license Additional Requirements: Knowledgeable in behavioral health managed care and clinical assessment skills to align patient acuity
…current standards of care along with accurately interpreting participating Managed Care Organizations (MCOs) certification requirements. The UR Coordinator
… functions during the Joint Commission and regulatory compliance reviews and managed care organization interface.3. Practices and requires staff to demonstrate
…application of positive language principles + Knowledge of Medicare, Medicaid and Managed Care requirements + Progressive knowledge of community resources,
…distinguishes among payers + Maintain knowledge of contracted and non-contracted managed care organizations, including authorization requirements and how to
…and by cultivating relationships with other providers, local and state agencies, and managed care organizations. The PHP Director ensures the program is
…internal and external customers including the client, family, physician, Treatment Team and Managed Care Organization. + Works in partnership with the Physician
…to ensure accurate and timely appeals to third party payers in compliance with Managed Care contracts and government fee schedules. The Appeals Specialist will
…Externally, the UM Coordinator will interface with licensing and accrediting agencies, managed care companies, family members, and healthcare treatment agencies.