Managed Care Specialist

Full Time
Davison, MI
Posted
Job description

About Us

McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan, Indiana and Ohio. The McLaren system includes 14 hospitals in Michigan and Ohio, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, one of only 51 National Cancer Institute-designated comprehensive cancer centers in the U.S.


Position Summary:
Responsible to oversee the managed care insurance process related to all clients admitted to the agency for service which will encompass, but not be limited to, coordination of services, general inquiries, managed care authorization and other initial reimbursement issues.
Essential Functions and Responsibilities:
1. (1-7 is for Intake Duties) Educates VNA staff on the financial aspects of coverage for services and managed care.
2. Oversees that insurance authorization for services is obtained and communicates approval to appropriate staff.
3. Coordinates the documentation processing of all paperwork related to managed care referrals and inquiries accurately and in a timely manner.
#LI-AK1

Required:
  • High school graduate with business courses and/or post high school business training.
  • Minimum one-year general office, collection, medical billing or related experience.

Preferred:
  • Demonstrated experience in managed care/private insurance management home care related.
  • Knowledge of Insurance Verification Software.

Equal Opportunity Employer of Minorities/Females/Disabled/Veterans

Additional Information
  • Schedule: Full-time
  • Requisition ID: 23000848
  • Daily Work Times: 8:30 am - 5:00 pm
  • Hours Per Pay Period: 80
  • On Call: Yes
  • Weekends: Yes

Per Centers for Medicare & Medicaid Services (CMS) regulations, all McLaren employees must be vaccinated for COVID-19 by January 4, 2022. The regulation permits exemptions for employees with qualified medical disabilities or religious beliefs.

Equal Opportunity Employer

McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.

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