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Title: Forest Floor
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Managed Care Specialist NBH, in the beautiful Berkshires of Western Massachusetts, has an opportunity for an experienced Managed Care Specialist. Qualified candidates will have a minimum of an Associates Degree or equivalent work experience. Prefer four-year degree in Business with a concentration in Accounting or Finance. 3+ Years working with Managed Care Payers and contractual reimbursement. Knowledge of healthcare receivables in managed care networks. Bookkeeping or accounting knowledge is preferred. Strong computer skills and ability to interpret and support software applications including database and spreadsheet programs. Ability to assess and evaluate managed care contracts. Essential job functions include: Load managed care contract provisions and contract updates into Harvest. Download managed care accounts from A/R system (Meditech and SSI) and produce reports for evaluation of contract compliance. Test new and/or updated contract rates prior to implementation on the contract management system. Analyze and evaluate data for maximum benefit and outcomes to the organization. Keep management apprised of any payer discrepancy trends or contract management systems miscalculations. Analyze patient accounts to ensure compliance of all contractual agreements. Review account-specific problems for patient accounts staff. Review underpayments and initiates corrected billing when appropriate. File discrepancy appeals when insurance payers have not fulfilled contractual reimbursements. Post adjustments when expected reimbursements have been satisfied. Establish communications with Provider Representatives to resolve daily errors. For more information contact: Cheryl Garvie, Human Resources Generalist, NARH, 71 Hospital Ave North Adams, MA 01247.Call (413) 664-5283,Fax (413) 664-5393, e-mail [EMAIL PROTECTED] |
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