Precertification Specialist, Managed Care Experience Preferred at CommuniCare Health Services

Indianapolis, Indiana, United States -

Full Time

Start Date

Immediate

Expiry Date

01 Aug, 26

Salary

0.0

Posted On

03 May, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Precertification, Admissions, Managed care, Medicaid, Medicare, Clinical documentation, Customer service, Conflict resolution, Multitasking, Communication, Organization, Computer skills, Financial knowledge, Negotiation, Public relations

Industry

Hospitals and Health Care

Description

Job Address: 7465 Madison Avenue Indianapolis, IN 46227 Do you have previous Admissions experience with Managed Care? Due to continued growth, CommuniCare Health Services is currently seeking the right professional to fill the full time position of Pre-certification Specialist for its Central Intake Department, located in the Indianapolis, IN region. PURPOSE/BELIEF STATEMENT The Pre-certification Specialist assists in developing census and providing external and internal support throughout the admissions process. Previous experience required; Managed Care experience preferred. This position must work flexible hours. This is not a sales position and the workplace is in an office setting - not in a nursing home. This position will be overseeing pre certs for our Central Intake office with a team of 4 others for the entire Division in Ohio and Indiana for our skilled nursing homes Role is full time, hourly and involves some hybrid work You must have experience with Pre Certs/Admissions to be considered for this role Monday - Friday - Day Shift (full time) Wednesday 12pm-8pm on call for pre cert remotely from home Every 4th weekend -on call for pre cert remotely from home BENEFITS The Pre-certification Specialist is a full time, salaried position in a fun, team environment! At CommuniCare, you will enjoy competitive wages, commensurate with experience, and PTO plans. We offer you a menu of benefit options from life and disability plans to medical, dental and vision coverage, from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts. If you meet the requirements for Pre-certification Specialist, and you would like to be part of a World Class team of professionals,respond to this ad with your resume and salary history for confidential consideration. POSITION REQUIREMENTS Previous admissions experience required; Managed Care Precertification experience preferred. Must have knowledge of Medicaid, Medicare, and Managed Care procedures, as well as laws, regulations, and guidelines that pertain to skilled nursing. Knowledge of Corporate Business Management This position must work flexible hours Ability to work independently and as a team Superior customer service skills, including the ability to resolve conflict Good organization skills Ability to communicate effectively verbally and in writing Must be respectful and a team player Must maintain a professional appearance and demeanor Must maintain a high level of confidentiality in all aspects of the job Must be able to deal tactfully with team members, other staff, residents, and family members, visitors, government agencies, and the general public. Must have the ability to make independent decisions when circumstances warrant such action. Must be skilled at multitasking and have a sense of urgency to perform time sensitive processes. Must possess basic computer skills. JOB DUTIES AND RESPONSIBILITIES Perform all pre-certification processes for Admission. Establish and maintain a positive and professional relationship with current and potential Managed Care providers and work to ensure patient and provider satisfaction. Communicate with Interdisciplinary team daily to process managed care referrals for precertification approval. Organize and maintain documentation of clinical records for submission to managed care organizations. Maintain up-to-date financial knowledge of skilled operations, managed care contracts and provide accurate documentation of all services in order to assure accurate reimbursement from all payor sources. Demonstrate excellent communications, negotiation, and public relations skills. Demonstrate autonomy, organization, assertiveness, flexibility, and cooperation in performing job responsibilities. About Us A family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, to reach out with our hearts and touch the hearts of others. Through this effort we create Caring Communities where staff, residents, clients, and family members care for and about one another. Since 1984, CommuniCare Family of Companies has been committed to delivering exceptional person-centered care as a national leader in post-acute care for those that are chronically ill or have complex conditions. Our more than 150 skilled nursing, assisted living, and long-term care facilities deliver sophisticated and transformative care to nearly 16,000 residents and patients at any given time. CommuniCare employs more than 19,000 employees across six states (Ohio, Indiana, Maryland, Virginia, West Virginia and Pennsylvania). As a family owned and operated company, family and heart are woven into every aspect of our continuum of care. Our mission, to serve with pride, is evident and a quality residents, families and community partners have come to expect and trust. Dedicated to improving the lives of seniors, we put extraordinary service above all else. We continue to raise the bar and innovate wherever possible to deliver a higher quality of life for those far beyond our facilities. Because of this, our facilities are a better place for residents to live, patients to stay, employees to work and families to heal.

Responsibilities

The Pre-certification Specialist manages the precertification process for skilled nursing admissions and maintains relationships with managed care providers. They also coordinate with interdisciplinary teams to process referrals and ensure accurate reimbursement documentation.