• Job Description

  Req#: 5000951362306

  Requisition Number

  83678

  Position Type

  Full-Time

  City

  Philadelphia

  State

  PA

  Shift

  1st Shift - no week-ends

  Work Schedule

  Monday thru Friday 8:00am to 4:30pm

  External Description

  Are you looking for an opportunity to advance your career while working with an extraordinary team? At Merakey, we put heart and soul into everything we do. We are seeking a Managed Care Coordinator to join our team at our program in Philadelphia, PA location.

  Earn $17.50/hour!

  The position of managed care coordinator consists of the following:

  • Interact with physicians, Merakey staff (Nurses, Adaptive Equipment Specialist, Motor Development Specialist, PT, OT, ST, Administrators, etc.), 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, Merakey Fiscal Department and family contacts, as needed, to obtain resolution.
  • Maintain current client insurance information by working with Social Services, Fiscal Dept. and family contacts.
  • Establish and maintain various file systems, as directed.
  • Travel to various Merakey facilities to consult with the physician and Merakey staff to retrieve information from charts, as needed.
  • Attend 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.
  • Assist in reconciliation and tracking of Warehouse orders/deliveries and assist in resolving any discrepancies.
  • Perform related duties, special assignments and projects as required

  BENEFITS

  Merakey offers competitive compensation plans, Work/Life balance, flexible schedules , cell phone discount plan, employee referral bonuses, tuition reimbursement and much more!

  To fill out an on-line application: www.merakey.org/careers

  Requisition number: 83678

  ABOUT MERAKEY

  Merakey is a leading developmental, behavioral health, and education non-profit provider with a fifty-year history. We offer a breadth of integrated services to individuals and communities across the country. Our belief that every individual has the right to achieve growth, dignity, and fulfillment guides all of our decisions. At Merakey, we care about each other and are committed to providing the very best care to those we serve. 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.

  Requirements

  The ideal candidate will possess the following qualifications:

  • High School Diploma or GED Required
  • Knowledge of medical terminology.
  • Excellent organizational skills and attention to detail.
  • Must be able to communicate effectively both orally and in writing.
  • Ability to prioritize assignments and work independently.
  • Good interpersonal skills, internally and outside of Merakey.
  • Good reading and interpretive skills.
  • Must be able to handle confidential matters with discretion.
  • Competence in computer skills and basic office equipment.
  • Knowledge of medical/insurance billing.
  • Knowledge with letters of medical necessity, medical exceptions, authorization process.

• About the company

  We believe that everyone deserves a chance to reach their fullest potential. Since 1969, we’ve worked every day to enrich the lives of individuals, families, and communities.

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