Job Opportunities in United States


September 20, 2024

Walker Healthforce, LLC

CONTRACT


Managed Care Coordinator | Remote | Contract

Managed Care Coordinator | Remote | Contract

Walker Healthforce is seeking a Managed Care Coordinator for a healthcare client located remotely. This is a contract position.

START DATE: ASAP

Walker Healthforce Standard Perks:
  • Weekly pay via Direct Deposit
  • Medical, Dental, and Vision Available
  • 401K

JOB DESCRIPTION
  • Reviews service requests for completeness and transfers non-clinical data and structured clinical data from physicians/patients.
  • Screens pre-certification requests via calls or correspondence following scripts/workflows under clinical staff oversight.
  • Prepares, documents, and routes cases for clinical review.
  • Initiates callbacks and correspondence with members/providers to clarify benefits and case completion.
  • Reviews claims and medical policy issues in pending status.
  • Authorizes services using scripts or algorithms for pre-review screening (non-clinical staff do not interpret clinical info).

JOB REQUIREMENTS
  • 1-2 years of customer service experience
  • Knowledge of medical terminology
  • Knowledge of contracts, enrollment, billing & claims coding/processing
  • Prefer knowledge Managed Care principles
  • Proficient with Microsoft applications (Excel, Outlook etc.)

PREFERRED JOB REQUIREMENTS
  • Bachelor’s degree

Contact our Recruiting Team today to experience the Walker Healthforce difference!

ABOUT US
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!

We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.

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