CenterWatch

1+ months

Managed Care Coordinator

Kelly Services
Marshfield, WI 54449
**Job Description**


Kelly Services is looking for Managed Care Coordinators for well known nonprofit medical clinic in Marshfield, WI, whose mission is to enrich lives through accessible, affordable, compassionate heath care.


JOB SUMMARY:

The Managed Care Coordinator completes insurance managed care requirements and provides case management as needed for services performed in the inpatient, outpatient, Ambulatory Surgery Center and provider office settings. The Managed Care Coordinator obtains and provides insurance benefit information to patients and medical departments. The Managed Care Coordinator assists patients and providers with developing strategies for alternative options for non-covered services by communicating with the provider, patient, insurance carrier and Patient Assistance Counselor.


ESSENTIAL JOB FUNCTIONS:

1. Regular attendance is an essential requirement of the position.

2. Completes insurance managed care requirements ((i.e. prior authorization, pre-notification, pre-certification, etc.) when needed for services ordered and/or provided by the clinic's providers.

3. Monitors services requiring case management by reviewing medical records, patient appointments and communicating with patients, patient care providers and insurance companies to ensure specific coverage requirements are met.

4. Contacts patient when necessary to obtain insurance or any other care related information in order to complete managed care requirements.

5. Communicates with patients and patient care staff regarding insurance coverage limitations and/or requirements.

6. Assists patients, staff and outside providers as needed with appeals and requests for retrospective referrals and prior authorizations.

7. Notifies Hospital Utilization Review and/or Admitting offices of reviews completed for urgent, elective, uninsured/underinsured admissions and outpatient procedures that require discharge planning after admission.

8. Reviews Ambulatory Surgery Center (ASC) and Hospital surgery schedule(s) to verify Pre Admission Review application (PAR) existence, accuracy and completion. If necessary, notifies and obtains missing information from medical department.

9. Assists in coordination, training of PAR, education and communication of managed care requirements to patients, physicians and employees.

10. Refers under-insured/uninsured patients and/or point-of-service pre-payment required services to Patient Assistance Counselors.

11. May interview and counsel under-insured and uninsured patients in specialty care areas to determine financial eligibility healthcare coverage programs.


**Requirements**


EDUCATION:

High school graduate or equivalent. Medical terminology required.


Preferred Education: Graduate of a Medical Assistant, Health Unit Coordinator or Health Care Business Service program preferred.


Experience:

Minimum Experience Required: A minimum of three years experience in medical business office, health care setting or comparable experience required. Prior experience should include working with and obtaining insurance eligibility and benefit information.


**Highlights**


Hours are between 7am-5pm M-F, can pick any 8 hour shift during those hours.


To apply, send your resume to: 3426@kellyservices.com or call 507-282-1584


**Why Kelly** **** **?**



As a worker today, its up to you to take charge of your career and look for opportunities to learn, grow, and achieve your potential. Helping
you find whats next is what were all about. We know whats going on in the evolving world of workjust ask the nearly 500,000 people we employ
each year. Connecting with us means getting the support, guidance, and opportunities needed to take your career where you may have never imagined.




**About Kelly** ****



At Kelly, were always thinking about whats next and advising job seekers on new ways of working to reach their full potential. In fact, were a
leading advocate for temporary/nontraditional workstyles, because we believe they allow flexibility and tremendous growth opportunities that enable
a better way to work and live. Connecting great people with great companies is what we do best, and our employment opportunities span a wide variety
of workstyles, skill levels, and industries around the world.


Kelly is an equal opportunity employer committed to employing a diverse workforce, including, but not limited to, minorities, females,
individuals with disabilities, protected veterans, sexual orientation, gender identity. Equal Employment Opportunity is The Law.

Categories

Posted: 2019-09-06 Expires: 2019-12-09

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Managed Care Coordinator

Kelly Services
Marshfield, WI 54449

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