Provider Partners Health Plan
A&G Coordinator
4 days agoWhat's your preference?
Job Description
- Req#: 678-01
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on compliance and stakeholder communication
- Involvement in audit discussions and process improvements
- Work with a diverse range of stakeholders, enhancing professional relationships
What to Expect (Job Responsibilities):
- Execute basic administrative duties as defined by the Senior Manager of UM, AG, & Benefit Services, utilizing reporting and database systems
- Serve as the A&G liaison between the FDR vendor and the Health Plan
- Develop relationships with the FDR vendor to enhance communication regarding process improvements
- Assist with the administrative tracking of audits and reporting
- Participate in audit discussions and support the A&G Auditor with preparation and functions related to audit findings
What is Required (Qualifications):
- Prior managed care experience, including knowledge of CMS
- Knowledge of ICD 10 and CPT/HCPCS codes and medical terminology
- Strong understanding of claims, authorizations, and appeals workflow processes
- Detail-oriented with the ability to prioritize multiple tasks and meet deadlines
- Familiarity with healthcare management software and Microsoft Office Suite (Excel, Word, PowerPoint)
How to Stand Out (Preferred Qualifications):
- Excellent organizational skills and strong verbal and written communication abilities
- Strong interpersonal skills with the ability to build relationships and work collaboratively with external partners and internal teams
#HealthcareServices #ManagedCare #Compliance #AuditSupport #CareerGrowth
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