Managed Care Coordinator

Managed Care Coordinator

We are currently seeking a Managed Care Coordinator to join our Intellectual and Developmental Disabilities Services (IDD) division.

Responsibilities include:

• Interface with physicians, AVS staff, Durable Medical Equipment vendors, pharmacy, etc. to obtain documentation, facilitate billing and coordinate follow-up.
• Communicate with family regarding insurance questions, issues, changes, etc.
• Complete, submit and track all letters of medical necessity, medical exceptions and other documentation, resubmissions, approvals, rejections and billing for physical/medical consults, therapies, durable medical equipment/supplies, and other services needed by the individuals and paid for by insurances.
• Coordinate referrals for physician, therapy services, testing and DME needs.
• Coordinate the appeals process on behalf of the physician, as needed.
• Contact area physicians and needed medical services to find those participating in the network.
• Respond to billing inquiries and work with providers, Fiscal, and family contacts, as needed, to obtain resolution.
• Maintain current client insurance information by working with Social Services, Fiscal, and family contacts.
• Establish and maintain various file systems, as directed.
• Travel to various AVS facilities to consult with the physician and AVS staff to retrieve information from charts, as needed.
• Attending Managed Care related meetings which minimally includes House Manager, Pharmacy and Therapeutics, Pre-admission, as well as regular meetings with the Health Services Supervisors to discuss any outstanding issues.
• Respond to insurance inquiries and provides required information and documentation.
• Perform related duties, special assignments, and projects, as required.

Earn $21.00/hour in this position.

Benefits

Merakey offers generous benefits that promote well-being, financial security, and work-life balance, including:

• Comprehensive medical, dental, and vision coverage, plus access to healthcare advocacy support.
• Retirement plan -- both pre-tax and Roth (after-tax) options available for employee contributions.
• DailyPay -- access your pay when you need it!
• On the Goga well-being platform, featuring self-care tools and resources.
• Access Care.com for backup childcare, elder care, and household services.
• Confidential counseling, legal, and financial services through our Employee Assistance Program (EAP).
• Tuition reimbursement and educational partnerships.
• Employee discounts and savings programs on entertainment, travel, and lifestyle.
• Access to Pryor Online Learning for free online personal development classes.

About Merakey

Merakey is a non-profit provider of developmental, behavioral health, and education services. More than 8,000 employees provide support to nearly 40,000 individuals and families throughout 12 states across the country each year. Merakey strictly follows a zero-tolerance policy for abuse.

Merakey is proud to be an Equal Opportunity Employer! We deeply value diversity and do not discriminate on the basis of race, religion, color, national origin, ethnic background, sex, gender, gender identity, sexual orientation, age, marital status, veteran status, genetic information, or disability status. Moreover, we are committed to creating teams that reflect the diversity of the communities we serve and encourage applicants from underrepresented backgrounds to apply. Merakey welcomes all Veterans to apply!

Qualifications:

• High school diploma, business school background preferred.
• Experience/training in a medical office/insurance company required.
• Must be familiar with the managed care field, computer literate or able to learn Microsoft Office.