Eli Global

Managed Care Specialist- Weston, FL

1 month ago
Job ID
2017-2290
# of Openings
1
City
Weston
Job Location
FL
Category
Administrative/Clerical

Overview

Eye Care Leaders is seeking a Managed Care Specialist to gather Fee Schedules from various  vision companies, interpret the data, and then create a master database inside our software.  The person in this role will be responsible for ongoing maintence of  Fee Schedules, as wel as Reporting and Support on our clients as needed.

 

Qualifications

To be successful in this position, the candidate should demonstrate a strong knowledge and understanding of medical billing and coding related to vision coverage:

 

  • Minimum of 2 years office experience in an Optical establishment or medical billing center.
  • Advanced understanding of health insurance billing practices, medical terminology, HIPAA guidelines, ICD/CPT codes, UB04 and HCFA 1500 preferred.
  • Knowledge of medical/vision requirements and coding guidelines.
  • Professional interpersonal and phone communication with clients, coworkers and management.
  • Ability to follow oral and written instructions.
  • Ability to multi-task
  • Detail oriented; data and report analysis and application.
  • Self-directed; excellent time management skills

Eye Care Leaders is an Equal Opportunity Employer. This company does not and will not discriminate in employment and personnel practices based on race, sex, age, handicap, religion, national origin or any other basis prohibited by applicable law. Hiring, transferring, and promotion practices are performed without regard to the above listed items.

Responsibilities

  • Read and interpret Insurance benefit details
  • Create national plan database setup in software
  • Educate clients how to build custom plan database (as needed)
  • Update and maintain vision plan setup accuracy
  • Prepare reports (as needed)
  • Troubleshoot discrepancies with plan benefit vs system
  • Update and maintain master Spectacle Lens list
  • Organizes work/resources to accomplish objectives and meet deadlines
  • Maintains compliance with federal, state and local regulations, and HIPPA law
  • Maintains compliance with established corporate and departmental policies and procedures, quality improvement program, customer service and productivity expectations
  • Maintains stable performance under pressure and handles stress in ways to maintain relationships with patients, clients and co-workers
  • Consistently demonstrates a positive and professional attitude
  • Responsible for other relevant work functions, as requested

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