Managed Care Claims Validator - Billing Accuracy

Communicare; Blue Ash, Northern (OH, KY); Hybrid; USD 42,000 - 66,000; Full time

Benefits offered by this job

PTO plans

Competitive wages

Job summary

CommuniCare Health Services in Blue Ash, OH is seeking a full-time Managed Care Claims Validator for our Central Billing Office. The role focuses on accurate filing of managed care claims, validating PCC data, and ensuring timely submission.

You will collaborate with the CBO cash teams, MDS, Case Management, and regional finance to uphold billing standards. The ideal candidate has strong medical billing knowledge, precise data validation skills, and the ability to work independently to resolve

Qualifications

• Knowledge of medical billing/collection practices.
• Strong attention to detail and accuracy.

Responsibilities

• Validate claim information against PCC data and carrier requirements.
• Check clearing house daily for claim rejections and resolve issues.
• Ensure managed care claims are validated and billed within 10th business day after close.
• Identify payer setups and update in PCC as needed.
• Attend in-services and provide guidance on billing compliance.

Skills

Medical billing

Attention to detail

Strong math & communication

Independent decision making

Education

High School diploma or GED

Tools

PCC software

Claims processing systems

Job description

CommuniCare Health Services in Blue Ash, OH is seeking a full-time Managed Care Claims Validator for our Central Billing Office. The role focuses on accurate filing of managed care claims, validating PCC data, and ensuring timely submission.

You will collaborate with the CBO cash teams, MDS, Case Management, and regional finance to uphold billing standards. The ideal candidate has strong medical billing knowledge, precise data validation skills, and the ability to work independently to resolve