Managed Care Coordinator Sr.

Overview:
Facing cancer takes great strength and courage. It also takes an exceptional team of Managed CareCoordinator Sr working alongside clinical and administrative staff and being a part of our patient's experience in our clinics.
If you like coordinating, processing, Managed Care function by auditing and maintaining Managed Care contract, we want you to join our team.
About Us:
Our mission is to increase access to and advance the delivery of high-quality cancer care in America. As part of US Oncology, one of the nation's largest healthcare services networks dedicated exclusively to cancer treatment and research, we can quickly bring the latest advances in cancer care to our patients. Most importantly, we understand the special needs of cancer patients, and are devoted to caring for the whole person, not just the disease. Our physicians and staff treat patients in over 17 locations throughout the state including Goodyear, Green Valley, Phoenix, Prescott Valley, Scottsdale, and Tucson.

Arizona Oncology has been recognized as one of the Top 100 Places to Live and Work in Arizona!
Benefits:
We offer competitive pay and a comprehensive benefit package that includes, 401K Profit Sharing Plan, Critical Care Insurance, Dental Insurance, Health Spending Account, Legal Insurance, Long-Term Care, Medical Insurance, Paid Time Off Plan, Short and Long-Term Disability, Tuition Reimbursement, Vision Insurance.
To make a difference in someone's life, you don't have to be brilliant, rich, beautiful or perfect. You just have to care.
Responsibilities:
In your job, you will have the ability to make a difference in a patient's journey by:

• Responsible for entering payer contracts/rates for the practices into practice management system.
• Maintains and coordinates updates from payers to contract fee schedules within the Practice Management System.
• Audits Managed Care contracting rates and terms in management system ensuring rates are accurate and complete to contract. Provides contract summary sheets to revenue cycle staff regarding health plan limitations and restrictions.
• Monitors and communicates contract changes to revenue cycle staff. Answers routine and general contract term questions.
• Monthly, produces Managed Care paid claims reports. Reviews reports and verifies that paid claims are in compliance with contracted rates. Contacts third party payers to resolve issues and submits appeal in order to obtain outstanding payments. Tracks payer denial trends and notifies management of significant changes.
• Updates and maintains current provider licensure files for contracted physicians, practitioners, and nurses. Completes state medical license applications and payments to appropriate agencies ensuring applications are accurate, complete, and filed timely. Follows-up with state medical licensure boards on status of license applications. Notifies providers of any licensure expirations.
• Maintains contracting metrics and runs appropriate reports to obtain statistics. Drafts presentations and materials for contracting meetings.
• Trains new coworkers on policies and procedures. Double checks co-workers work and provides procedure guidance. May research, resolve, or provide direction on co-workers escalated issues.
• Proactively identifies processes and procedures gaps and develops tools to improve efficiencies.
• Other duties as requested or assigned.
• This is a Hybrid position with work at home and on-site.

• High school diploma or equivalent required.
• Associate Degree in Finance, Business or four years revenue cycle experience preferred.
• Minimum of two (2) years Managed Care and credentialing experience as well as four (4) years combined medical billing and payment experience required.
• Medical coding experience required.
• Some medical office experience required, preferably in oncology.
• High computer literacy required.
• Working knowledgeable of state, federal, and third-party claims processing required.
• Excellent customer service skills as daily interaction and troubleshooting with physicians and clinical staff is required.

• Associate Degree strongly desired; Bachelor's Degree preferred.
• Experience in Microsoft Office.
• Experience with computer data entry and database management.
• Excellent written and oral communication skills.
• High attention to detail and accuracy.
• Ability to independently organize, prioritize, and make decisions.
• Any relevant experience which demonstrates the minimum knowledge and skills may be substituted for education.