Managed Care Coordinator jobs in West Virginia

Managed Care Coordinator coordinates utilization reviews of managed care contracts using established guidelines and processes. Ensures all clinical operations comply with Medicare and Medicaid guidelines and other managed care policies. Being a Managed Care Coordinator communicates with physicians, discharge planners and others to process referrals, authorization for services, and capture data related to utilization. Maintains managed care contracts and information databases and prepares reports. Additionally, Managed Care Coordinator typically requires an associate degree in nursing. Typically reports to a supervisor or manager. Typically requires Registered Nurse (RN). The Managed Care Coordinator has gained full proficiency in a broad range of activities related to the job. Independently performs a wide range of complex duties under general guidance from supervisors. To be a Managed Care Coordinator typically requires 5-7 years of related experience. (Copyright 2024 Salary.com)

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Managed Care Biller
  • CommuniCare Family of Companies
  • Charleston, WV FULL_TIME
  • Managed Care Biller

    Due to Company growth, CommuniCare Health Services is currently recruiting a Managed Care Biller for our Central Billing Department. This position will be based in our Central Billing Office located in Charleston, WV, but it can be remote if the employee lives more than an hour's commute from Charleston.

    PURPOSE/BELIEF STATEMENT

    The position of Managed Care Biller/Collector is responsible for billing, receivables auditing, and collections activities for services provided to patients in the facilities assigned. Ultimately they are responsible for hitting their cash collection goals each month and minimizing the impact of Bad Debt for the buildings/facilities assigned to them.

    WHAT WE OFFER

    All CommuniCare employees enjoy competitive wages and PTO (Paid Time Off) plans. We offer full time employees a menu of benefit options that include:

    • Life Insurance and Disability Plans
    • Medical, dental, and vision coverage from quality benefit carriers
    • 401K with employer match
    • Flexible Spending Accounts

    POSITION REQUIREMENTS

    • Knowledge of medical billing/collection practices.
    • 3-5 years experience in managed care billing preferred
    • Experience billing various Managed Care companies and understanding the requirements for each payor
    • Claim appeal/resolution expertise preferred
    • Must have a high degree of attention to detail.
    • Strong verbal and written skills required in order to interact with insurance companies to resolve unpaid claims via telephone and written correspondence.
    • Basic computer literacy and skills.
    • Strong organizational skills a must.

    About Us

    A family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients, and family members care for and about one another.

  • 8 Days Ago

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Managed Care/ Payer Enrollment Specialist
  • Mon Health
  • Morgantown, WV FULL_TIME
  • With a patient centered culture, the Managed Care/Payer Enrollment Specialist will manage daily activities related to providing operational support for Payer Enrollment. This role manages accounting a...
  • 30 Days Ago

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Spiritual Care Coordinator
  • WVUHS Home Care, LLC
  • Morgantown, WV FULL_TIME
  • Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. B...
  • 25 Days Ago

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Care coordinator
  • PRESTERA CENTER FOR MENTAL HEALTH
  • Danville, WV FULL_TIME
  • Job Details Description Job Title : Wraparound Care Coordinator FLSA Status : Non-Exempt Reports to : Regional Partnership Grant Director Department : Clinical Preparation Date : May 2023 CENTER’S MIS...
  • 8 Days Ago

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Clinical Coordinator
  • DaVita Kidney Care
  • Wheeling, WV FULL_TIME
  • 500 Medical ParkSuite 100, Wheeling, West Virginia, 26003, United States of AmericaDaVita is seeking a Clinical Coordinator who is looking to give life in an outpatient dialysis center. You can make a...
  • 5 Days Ago

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Point of Care Coordinator OR POC Coordinator
  • KA Recruiting
  • Hinton, WV FULL_TIME
  • This job offer is not available in your country. Job Description Position : Point of Care Coordinator Shift : Day Shift Location : Southern West Virginia Requirements : BA / BS or AA / AS in laborator...
  • 2 Days Ago

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Managed Care Coordinator
  • Mindlance
  • Columbia, SC
  • Job Title: Managed Care Coordinator Job Location: Columbia, SC Top 3/5 Skills: · RN / Registered Nurse License · Chronic...
  • 6/11/2024 12:00:00 AM

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Managed Care Coordinator
  • MJHS
  • New York, NY
  • Req #: 1509 Job ID: 13084 Job Location: New York, NY Zip Code: 10040 Category: Office and Administrative Support Agency:...
  • 6/10/2024 12:00:00 AM

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Case Manager (Care Coordinator)
  • Pacifica Hospital of the Valley
  • Los Angeles, CA
  • Job Description Job Description CARE COORDINTOR (CASE MANAGER) BEHAVIORAL HEALTH URGENT CARE CENTER (OUTPATIENT CLINIC) ...
  • 6/9/2024 12:00:00 AM

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Sales Manager/ Care Coordinator
  • Always Best Care Senior Services
  • Thousand Oaks, CA
  • Sales Manager / Care Coordinator Always Best Care, a National home care company, is currently looking for a seasoned, en...
  • 6/9/2024 12:00:00 AM

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Managed Care Coordinator - Foster Care
  • Elevance Health
  • Radford, VA
  • Description The Foster Care Managed Case Manager is responsible for overall management of member's individual service pl...
  • 6/9/2024 12:00:00 AM

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Credentialing and Managed Care Coordinator
  • Texas Oncology
  • Richardson, TX
  • Overview: The US Oncology Network is looking for a Credentialing and Managed Care Coordinator to join our team at Texas ...
  • 6/8/2024 12:00:00 AM

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Case Manager (Care Coordinator)
  • Pacifica Hospital of the Valley
  • Los Angeles, CA
  • Job Description Job Description CARE COORDINTOR (CASE MANAGER) BEHAVIORAL HEALTH URGENT CARE CENTER (OUTPATIENT CLINIC) ...
  • 6/8/2024 12:00:00 AM

5
office manager/ care coordinator
  • 5 Stars Home Care LLC
  • Alexandria, VA
  • Job Description Job Description Job Summary: Duties: Responsible for all areas of Operations; human resources, intakes, ...
  • 6/7/2024 12:00:00 AM

West Virginia (/vərˈdʒɪniə/ (listen)) is a state located in the Appalachian region in the Southern United States and is also considered to be a part of the Middle Atlantic States. It is bordered by Pennsylvania to the north, Maryland to the east and northeast, Virginia to the southeast, Kentucky to the southwest, and Ohio to the northwest. West Virginia is the 41st largest state by area, and is ranked 38th in population. The capital and largest city is Charleston. West Virginia became a state following the Wheeling Conventions of 1861, after the American Civil War had begun. Delegates from so...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$44,509 to $76,388

Managed Care Coordinator in New Orleans, LA
Health systems must meet the operational challenge of managing provider data for thousands of participating providers in their value-based care networks.
January 11, 2020
Managed Care Coordinator in Gainesville, FL
Many telehealth programs give patients easy access to any additional educational materials provided by their health plan or primary care provider.
December 23, 2019
Managed Care Coordinator in Houston, TX
Works with relevant parties to ensure deliverable from all parties are achieved in accordance with strategic timelines.Maintains CHSLI master list of service locations (facility, professional and continuing care)Assists in the resolution of referral, authorization and claims payment issuesSupports Directors in effort to educate and assist Hospital departments in meeting internal and MCO operational requirements.
December 27, 2019