Senior Managed Care Coordinator in Nashville at Parallon

Date Posted: 10/24/2018

Job Snapshot

Job Description

GENERAL SUMMARY OF DUTIES - Develops and maintains Joint Operations Committee processes.
Produces reports for JOC, and works closely with Directors to provide analysis and updates.

DUTIES INCLUDE BUT ARE NOT LIMITED TO:
Develops and maintains reports to support the JOC escalation processes.
 Serves as a liaison between Parallon leadership, hospital leadership, and payer contacts.
Works with Parallon managers to identify, escalate, and resolve payer trends and individual claims
concerns.
 Creates and maintains JOC call schedules, meeting invites and appropriate attendees, Agendas, and
Meeting Minutes.
Works with payer contacts to resolve patient or payer claims complaints.
Reviews escalation files and emails for completeness, and coordinates with managers to ensure quality
of materials exchanged with payer contacts.
 Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”
 Other duties as assigned

Job Requirements

KNOWLEDGE, SKILLS & ABILITIES
 Communication - communicates clearly and concisely, verbally and in writing
 Customer orientation - establishes and maintains long-term customer relationships, building trust and
respect by consistently meeting and exceeding expectations
 Interpersonal skills - able to work effectively with other employees, patients and external parties
 PC skills - demonstrates proficiency in Microsoft Office applications and others as required
 Policies & Procedures - demonstrates knowledge and understanding of organizational policies,
procedures and systems
 Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate
properly, spell correctly and transcribe accurately
 Financial analysis skills - knowledge of research techniques sufficient to collect and interpret data.
Skill in interpreting and analyzing data. Skill in examining documents for correctness and
interpreting their accuracy.
EDUCATION
 Bachelor’s degree ifrom 4 year College or University. Relevant experience may
substitute for education requirements.
EXPERIENCE
 At least one year payment compliance / logging experience required. Managed Care experience preferred.
 Relevant education may substitute experience requirement