Regional Medicare and Managed Care Specialist
The primary purpose of this position is to assist all CT iCare managed facilities with Medicare and Managed Care collections and provide guidance, direction and leadership to all on-site facility business office staff.
Responsibilities:
•Monthly tracking of facility Medicare, Managed Medicare, Insurance and Part B claims to ensure billed timely
•Provide assistance/completing corrected claims for Medicare, Managed Medicare and Insurance claims
•Provide assistance/completing reconsiderations and appeals for Medicare, Managed Medicare and Insurance claims
•Monthly review of Medicare, Managed Medicare and Insurance aging reports to review for payment issues and trends
•Provide assistance/completing Medicare Secondary Payer claims
•Optum A informational claims for all Optum contract buildings
•Reviewing DDE for kickback claims that are not corrected timely
•Third Eye physician billing for TAB & TAM
•Vaccine billing for all facilities - influenza, covid and pneumonia
•Assisting with month end close as needed
•Assisting with census coverage as needed
•Assisting with month end triple check as needed
•Maintaining insurance website login’s for Business Office
•Training/retraining Business Office staff on correct billing procedures
Qualifications:
- Working knowledge of various software programs, required.
- Must have experience in long term care business office functions.
- Knowledge of Medicare billing procedures, required.
- At least 5 years experience in Managed Care billing.
- Bachelors in Accounting, Finance or related area, preferred.
- Must be highly organized with strong verbal and written communication skills.
Compensation & Benefits
- Salary starting at $80,000, commensurate with experience
- Occasional hybrid work opportunities
- Benefits program, includes health, dental, and vision insurance
- Paid Time Off, including vacation, personal, and sick time
- 401(k) Retirement program
- Short and Long-term disability insurance
- Collaborative work environment
INDLP
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