About this opportunity
CommuniCare Corporate lists this Precertification Specialist, Managed Care Experience Preferred opportunity in indianapolis, Indiana. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Pre-certification SpecialistDue 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.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. 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.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 RequirementsPrevious 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 ManagementThis position must work flexible hoursAbility to work independently and as a teamSuperior customer service skills, including the ability to resolve conflictGood organization skillsAbility to communicate effectively verbally and in writingMust be respectful and a team playerMust maintain a professional appearance and demeanorMust maintain a high level of confidentiality in all aspects of the jobMust 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 ResponsibilitiesPerform 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.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.
Worksite address
indianapolis, IN, 46227, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.