…triggers. Qualifications & Requirements: 0-2 years of Utilization Review experience and Managed Care experience. Familiarity with Medicaid and Medicare claims

…coding either in a hospital or physician setting 3+ years of experience in managed care with knowledge of RAPS 3+ years supervisory experience Certified

…one-year experience preferred in healthcare credentialing (ie, healthcare facility, managed care setting, credentials verification organization, or Medical

…health information system is required. Knowledge of third party payers including managed care , Medicare, Medicaid, and Workers Comp is highly desirable.

…and facilitate the timely and accurate submission of claims by Managed Care , Medicare and/or Medicaid billers.Essential Duties and Responsibilities:Submits

…accurate call and activity guidelines Verifies patient's co-payments and benefits with Managed Care Organization and update patient account accordingly Prepare

…Knowledge: Healthcare (professional) billing; knowledge of CPT/ICD-10 coding, government, managed care and commercial insurances, claim submission requirements,

…HHS, HIPAA Privacy Experience working collaboratively with IT, HIMS, Finance, Compliance, Managed Care , Business and Clinical Operations are important. Strong

…audit activities for compliance related to internal policy, CMS, Medicaid and managed care regulations and requirements, communication, outcomes analysis and

…with focused expertise in the areas of practice management and development, managed care contracting and credentialing, strategic planning, financial and