Managed Care Coordinator

🕒 5 days ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $22 - $30 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 11%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Beth Israel Lahey Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Beth Israel Lahey Health is a comprehensive healthcare system providing a wide range of medical services and care options to communities in Massachusetts and New Hampshire. With a network of 14 hospitals, including community hospitals and specialized centers for orthopedic and behavioral health care, they offer personalized care for all health needs. Their services include emergency care, primary care, urgent care, pharmacy services, home care, and more. Dedicated to improving community health and well-being, Beth Israel Lahey Health is committed to research, education, and providing extraordinary care through its 39,000 team members.

📋 Description

• Initiate and process managed care insurance referral requests for patients of BILH Primary Care Practices. • Coordinate and process specialty care managed care referral authorization requests for multiple managed care insurance payers. • Use electronic technologies to initiate, issue, and administratively sign off on a high volume of referrals. • Serve as a daily point of contact and organizational resource for patients, families, specialty practices, physicians, and support staff on managed care issues. • Communicate authorized care levels, visit numbers, and diagnostic testing scope to specialists and patients. • Resolve referral management issues with managed care payers and coordinate with internal and external customers to resolve billing problems. • Provide referral management training to new hires. • Maintain knowledge of referral and authorization plan rules and policies across payers, specialties, and diagnostic testing. • Retrieve referral requests from Clinical Computing, Patient Site, OMR notes, emails, nurse triage, and patient voicemails; process referrals and communicate information promptly. • Collaborate with the team on new patients' referral management issues and questions.

🎯 Requirements

• High School diploma or GED required. • License Medical Admin Assistant Cert preferred. • 1-3 years related work experience required. • Experience with computer systems required, including web-based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access. • Must adhere to patient confidentiality policies. • Must be vaccinated against influenza (flu) as a condition of employment.

🏖️ Benefits

• Influenza vaccination required as a condition of employment • Equal Opportunity Employer/Veterans/Disabled