Our Vision is to be the best choice for healthcare in our communityThis posting is for a FULL-TIME Managed Care Coordinator within our Family Practice office in Dade City. This role is responsible for assisting providers, supervisors, and staff members with all aspects of the managed care plans. Qualified candidates must have a strong understanding of Medicare insurances and Excel spreadsheets, medical terminology. Five years of experience in a similar role preferred. Medical Assistant background a plus.WHAT DOES FLORIDA MEDICAL CLINIC ORLANDO HEALTH HAVE TO OFFER ITS EMPLOYEES?We offer a wide choice of compensation and benefit programs that are among the best. From competitive salaries to retirement plans. We make every effort to take care of the people who make our company great.Gives you an employer that you will have pride in working forProvides excellent training programs and opportunities for growthOffers Medical Benefits including:Employer Contributions to HSA high deductible planDiscounts at our medical facilitiesCigna Open Access OAPIN & OAP plansSupports Incentive based Wellness ProgramsOffers company sponsored Life Insurance with buy-up provisionsProvides Dental, Vision, Long and Short Term Disability, Accident & Illness policy optionsSupports Paid Time Off and HolidaysGives generous 401K plan with annual 3% Employer contribution after one year of employmentValues and appreciates its employeesBoasts a reputation for superior health care and quality serviceJob Qualifications:High school graduate or GEDStrong customer service orientationTime management and multitaskingOrganize and manage multiple prioritiesComputer proficienciesStrong team playerMaintains MRA data as required by Managed Care CarriersReviews and completes managed care report; suspect, Hedis , Prostar.Updates the Plan Code Audit for centerNormal physical ability; able to sit for long periodsNormal concentration and normal complexity of decision makingHigh level verbal and written communication skillsKeys to Success in this Role:Essential Functions of the Position:Acts as Case ManagerObtains approval from the provider for requested authorizationsCoordinates visitsNotifies patients of the appointmentsForwards clinical data to the treating provider and/or facilityNotifies specialist office and patient of denied requests for authorizationUses approved web tools to obtain authorizationsReviews hospital census daily and distributes information to supervisorsCoordinates admissions with providers and facilitiesAssists with coordination of care for patientAssist in managing care for Out of State patientsAssists with complicated referrals for Home Health, DME and denialsPhysician Staff SupportTrain new providers on play polices, MRA, Hedis.Updates providers and staff on changes in referral process, MRA and Part D coverage.Inputs providers into Practice Management.Works with supervisors and staff to promote team work.Maintains MRA data as required by Managed Care CarriersSubmits claim encountersReviews and completes managed care reports; suspect, Hedis reports and updates Estar.Addresses and handles all tasks in a timely mannerCoordinates meetings between providers/Medical DirectorsPrepares agendaTypes minutes of meetingsFollows through on all requests by providers.Provides reports to CFO (center totals, membership)Handles and returns referral related callsAdditional Responsibilities:Maintains an organized and clean work areaParticipates in maintenance of office suppliesPerforms other incidental and related duties as required and assignedPhysical and Mental Demands:Routine desk and office activitiesAbility to move frequently throughout the facility and to sit for long periods of timeHigh level verbal and written communication skillsAbove average ability to manage multiple tasks and projects simultaneouslyWe are an Equal Opportunity Employer and make employment decisions without regard to race, gender, disability or protected veteran status#IND123
