Corporate Accounts Receivable Support, Managed Care

Corporate Accounts Receivable / Managed Care Support Specialist

CommuniCare Health Services is currently recruiting a Corporate Accounts Receivable / Managed Care Support Specialist.

Purpose / Belief Statement

The A / R Managed Care Support Specialist will assist in the timely and expedited collection of cash from managed care payors. This role is expected to provide corporate support for the functions of accounts receivables escalation and resolution, denials management, payment variance, and contract modeling. Responsibilities also include tracking / trending performance metrics for the managed care book of business and providing intervention when metrics and outcomes are not achieved. This person will be responsible for conducting root cause analysis to both improve revenue and reduce denials. The Corporate A / R / Managed Care Support Specialist will work with managed care payors to identify and correct trends in over / underpayments. They will also be responsible for partnering with other internal departments to make sure contracts are set up properly in Point Click Care (PCC) and operationalized in the CBO and field.

This position manages our Clearinghouse (Prime Claims, formerly Quadax), provides backup support for PCC Setups, coordinates PCC Payer naming conventions and setups, provides Training & Education to the Division Teams, and assists with claims resolution. This person will work closely with our Managed Care Escalations and Support Team.

Qualifications

• College degree preferred, but will consider High School graduate with commensurate years of experience in healthcare billing and collections.
• Prior billing and collection experience in Long Term Care (Skilled Nursing) required.
• Prior knowledge of Point Click Care (PCC) preferred but not required.
• Excellent excel skills a plus!

Knowledge / Skills / Abilities

Our company offers competitive pay, PTO, and team spirit, along with an outstanding benefits package for full time employees.