Remote Managed Care Coordinator

Zangmeister Cancer Center; United States; Remote; USD 21,000 - 37,000; Full time

Job summary

Zangmeister Cancer Center is seeking a Managed Care Coordinator for a remote role aligned with Central or Eastern Time zones. You will act as the liaison between Financial Counseling and the Utilization Management team to coordinate managed care reviews, authorizations, and communications with payors and providers.

Responsibilities include pre-certification and prior authorization reviews, ensuring accurate EMR and billing data, and maintaining compliance with healthcare regulations.

Qualifications

• High school diploma or GED required.
• Experience in healthcare or clinical billing is preferred.

Responsibilities

• Monitors and coordinates pre-certification and prior authorization with insurance providers, including peer-to-peer reviews and appeals.
• Reviews patient schedules and treatment plans to evaluate coverage against payer guidelines.
• Verifies active insurance coverage and communicates unplanned exceptions promptly to the provider/clinic team.
• Identifies new treatment orders and ensures timely processing of required forms.
• Maintains proactive communication with Financial Counselor, Intake, UM teams, and other staff via Teams, phone, email, and in-person.
• Collaborates with external entities to complete forms and items needed on time.
• Ensures compliance with applicable federal and state laws pertaining to patient care, rights, safety, billing and collections.
• Occasional overtime may be required with sufficient notice.
• Keeps work area and records organized and maintains equipment in safe order.
• Adheres to Revenue Cycle policies and procedures and completes other duties as assigned.

Education

High school Diploma or GED

Tools

MS Office

Job description

Zangmeister Cancer Center is seeking a Managed Care Coordinator for a remote role aligned with Central or Eastern Time zones. You will act as the liaison between Financial Counseling and the Utilization Management team to coordinate managed care reviews, authorizations, and communications with payors and providers.

Responsibilities include pre-certification and prior authorization reviews, ensuring accurate EMR and billing data, and maintaining compliance with healthcare regulations.