Job description

Job Summary: Under general supervision of the Executive Director of Revenue Cycle, the Managed Care Coordinator is responsible for managing Payor contracts operational components for all identified payors (priority for BCBS, UHC, Managed Medicaid, Managed Medicare, Humana, Triwest, Loomis) for LCH, SMRMC and all employed owned clinics. Working with internal and external stakeholder partners to communicate and resolve issues and to enhance relationships. Working knowledge of contracts, Payor and billing reimbursement methodologies and strong problem solving/customer service orientation. Ability to root cause analyze issues and to propose solutions. Ability to market and communicate the care capacities and commitment to provision of quality care in our community by the integrated health system.

• Ensures current and accurate information regarding contracts, rates, fee schedules,policies and procedures which impact contract. Provider manuals and all documentation of communication between plan,Southwest Health, Lawrence County Hospital and all employed owned physicians and clinics.
• Assist in execution of payor strategies to develop renegotiation and revenue strategies.
• Demonstrate through understanding of competitive landscape in local market and federal state and regulatory issues which can impact Southwest Health and the importance of critical access and rural health clinic provider landscape.
• Able to manage joint operation committee (JOC) meetings by formulating meeting agenda and recording minutes from meeting and interfacing Provider Relations on claims, denials, and appeals issues identified.

Job Type: Full-time

Pay: From $20.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee discount
• Gym membership
• Health insurance
• Life insurance
• Prescription drug insurance
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• Office

Ability to commute/relocate:

• McComb, MS 39648: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Number of years with payor related experience?
• Do you have problem Solving and Solution Development approach, how many years?

Education:

• Bachelor's (Preferred)

Experience:

• Customer service: 3 years (Preferred)

Work Location: In person

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