Precertification Specialist, Managed Care Experience Preferred

CommuniCare Health; Indianapolis (IN); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Competitive wages

PTO plans

401(k) with employer match

Flexible Spending Accounts

Job summary

CommuniCare Health is seeking a Precertification Specialist in Indianapolis, IN. The role involves managing pre-certification processes, requiring admissions experience and knowledge of Medicaid and Managed Care. This full-time position offers a competitive salary and benefits including a 401(k) plan with employer match. Candidates must have excellent communication skills and the ability to work flexibly within a team. The work environment supports a positive culture focused on care and excellence in healthcare service.

Qualifications

• Previous admissions experience required; Managed Care Precertification experience preferred.
• Must have knowledge of Medicaid, Medicare, and Managed Care procedures.
• Must be able to deal tactfully with team members and the public.

Responsibilities

• Perform all pre-certification processes for Admission.
• Communicate with the interdisciplinary team daily to process managed care referrals.
• Organize and maintain documentation of clinical records.

Skills

Admissions experience

Managed Care knowledge

Customer service skills

Communication skills

Organizational skills

Education

Knowledge of Medicaid, Medicare, and Managed Care procedures

Tools

Basic computer skills

Job description

Precertification Specialist, Managed Care Experience Preferred page is loaded## Precertification Specialist, Managed Care Experience Preferredlocations: Hawthorne Healthcare Centertime type: Full timeposted on: Posted Todayjob requisition id: R-0000116968**Job Address:**7465 Madison AvenueIndianapolis, IN 46227Due 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.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.