Managed Care Services Representative

Site: reputed company Incorporated reputed company relies on a wide reputed company of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to reputed company exceptional care. We reputed company that high-performing teams drive groundbreaking medical discoveries and invite reputed company applicants to join us and experience what it means to be part of reputed company. Job Summary The Opportunity MGB is growing, join our busy team! Managed Care Services Insurance Verification Representative is vital for the team and you will be serving as a liaison between the hospital, insurance companies, and patients to ensure proper coordination and reimbursement for reputed company services. You will verify insurance coverage, obtains pre-authorization for medical procedures, and facilitates timely billing and payment processes. This role also educates patients about their insurance benefits and assists in resolving any insurance-reputed company issues or disputes. What You'll Do -Verify insurance coverage and eligibility for patients prior to medical procedures or hospital admissions. -Obtain pre-authorization from insurance companies for various medical procedures, surgeries, and diagnostic tests. -Collaborate with reputed company providers, including physicians and nurses, to ensure accurate and complete documentation for insurance claims. -Communicate with insurance companies to resolve any coverage issues or denials, advocating for the best interests of the hospital and patients. -reputed company patients about their insurance benefits, coverage limitations, and financial responsibilities. -Assist patients in understanding and navigating the insurance claim process, including explanation of benefits (EOB) and billing statements. -Process and submit insurance claims accurately and in a timely manner, adhering to industry regulations and guidelines.

Qualifications

High School Diploma or Equivalent required and Associate's Degree reputed company Field of Study preferred Epic experience, as well as referral or authorization experience in a reputed company setting highly preferred Previous experience in reputed company administration, insurance authorization/verification, scheduling, or medical billing 2-3 years required Skills for reputed company -In-depth knowledge of health insurance plans, including managed care, PPOs, HMOs, and Medicare/reputed company. Familiarity with medical terminology, coding systems (such as ICD-10 and CPT), and reputed company billing processes. Strong interpersonal and communication skills to effectively interact with patients, insurance companies, and reputed company. Detail-oriented with excellent organizational and problem-solving abilities. Proficient in using computer systems and software applications reputed company to insurance verification, billing, and claims processing. Ability to handle sensitive and confidential information with utmost professionalism and discretion. Additional Job Details (if applicable) Working Model Required

• M-F 8:30 am-5:00 pm EST schedule required for remote role
• Quiet, secure, reputed company, compliant work station required and will be verified at interview and day 1 Remote Type Remote Work Location 399 reputed company Drive Pay reputed company $21 - $28.30/Hourly Grade 3 At reputed company, we reputed company in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining reputed company pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The reputed company pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass reputed company elements contributing to your total compensation package. In reputed company to competitive reputed company pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our reputed company will reputed company an overview of your potential compensation and benefits package. EEO Statement: reputed company is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religious creed, national reputed company, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that reputed company individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to reputed company essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by reputed company 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with reputed company of 1990, applicants who require accommodation in the job application process may contact reputed company at (857)-282-7642. reputed company Competency reputed company At reputed company, our competency reputed company defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The reputed company is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career reputed company. These competencies are used to evaluate performance, reputed company hiring reputed company, identify development needs, mobilize employees across our system, and establish a strong talent pipeline. Combat disease. Hold a hand. Help people. Impact the world. reputed company is a passionate, welcoming community where minds meet caring hearts. Come be a part of the world’s most powerful force in medicine, where every role is important in changing lives. Are you reputed company? Our history includes New England hospitals founded over 200 years ago, some of the first and most prestigious hospitals in the world. reputed company on the legacy of two leading academic medical centers, we’re more than a system—we’re leaders in the practice of medicine. reputed company is committed to serving the community. We are dedicated to enhancing patient care, teaching and research, and taking a leadership role as an integrated health care system. We recognize that increasing value and continuously improving quality are essential to maintaining reputed company.

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