Care Management Payor Specialist
$40,144–$60,195 year
On-siteAnnapolis, Maryland, United States
Job Summary
Review daily case manager work lists to identify clinical reviews due to payors and report trends on delays to leadership. Communicate medical record information telephonically, via fax, or electronically to obtain authorizations for admissions, stays, and care levels, then verify payor responses and initiate corrective action for discrepancies. Assure case managers are informed of determinations and notified promptly of potential denials or additional information requests. Submit timely clinical feedback and complete Medical Assistance 3808s. Requires one year of billing/collection or Medicare, Blue Cross, and Medicaid experience.
Required Qualifications
- High school diploma or equivalent
- One year work experience to include billing/collection experience and/or experience with Medicare, Blue Cross and Medicaid
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