These examples do not include all possible tasks in this work and do not limit the assignment of related tasks in any position of this classification. Regular attendance according to the position's management approved work schedule is required for all positions. Assist individuals in gathering necessary verifications to determine eligibility for the Behavioral Health Fund

Synthesize and forecast industry trends, customer needs, competitive threats, survey insights, member experience best practices and internal and competitive performance to design industry leading customer service and health plan improvement strategies Serve as a subject matter expert in CAHPS measure specifications, member pain points, survey strategy and business operati

Make determinations of medical necessity/clinical appropriateness of treatment Assist in the development and implementation of clinical policy, guidelines and applications Regularly contact providers whose treatment determinations indicate a trend that varies with their peers and community Be knowledgeable on and apply all necessary regulatory requirements for assigned re

Make determinations of medical necessity/clinical appropriateness of treatment Assist in the development and implementation of clinical policy, guidelines and applications Regularly contact providers whose treatment determinations indicate a trend that varies with their peers and community Be knowledgeable on and apply all necessary regulatory requirements for assigned re

Coordinates the resolution of unpaid accounts. Receives and resolves calls from patients, insurance companies, attorneys, and departments. Obtains and processes payments. Collaborates with patients to create payment arrangements. Updates incomplete and missing account information. Documents collection activities. Other duties as assigned. You'll be rewarded and recognized

Make determinations of medical necessity/clinical appropriateness of treatment Assist in the development and implementation of clinical policy, guidelines and applications Regularly contact providers whose treatment determinations indicate a trend that varies with their peers and community Be knowledgeable on and apply all necessary regulatory requirements for assigned re

Collaborate cross organizationally in the development, proposing and prioritization of customer solutions to reduce trend (programs, processes, benefit design, network, etc.) Works with business partners to ensure are aligned with successfully achieving savings targets Development and execution of cross functional strategies, projects and tactics which result in increment

Follow established departmental policies, procedures and objectives Notify Provider Enrollment Manager of non compliance issues May involve travel to meet with providers to ensure complete and accurate forms are completed Completion of PIN form for submission to Excellian, track payer data in Symed Follow up on outstanding enrollment issues to ensure timely reimbursement

Serves as the clinical liaison with clinical performance and administrative staff as well as providing expertise solving member issues Makes outbound calls to assess members' current health status, as well as take inbound calls to resolve inquiries and assist members as needed. Warm transfer to other departments or services as needed Assesses patient needs using establish

Perform financial clearance processes by interviewing patients and collecting and recording all necessary information for pre registration of patients Educate patients of pertinent policies as necessary i.e., Patient Rights, HIPAA information, consents for treatment, visiting hours, etc Verify insurance eligibility and completes automated insurance eligibility verificatio

Make determinations of medical necessity/clinical appropriateness of treatment Assist in the development and implementation of clinical policy, guidelines and applications Regularly contact providers whose treatment determinations indicate a trend that varies with their peers and community Be knowledgeable on and apply all necessary regulatory requirements for assigned re

Compile, process, and maintain patient's health information in a manner consistent with medical, administrative, ethical, legal, and regulatory requirements of the practice in a timely manner. The Electronic Medical Records Technician responsibilities are in accordance with the Health Information Management procedures as it pertains to the Chart Prep, Radiology Pathology

This position provides operational leadership in partnership with the Executive Director and Program Directors in moving forward the mission of MNCASA. The Operations Director supports all areas of MNCASA, through a range of organizational strategic functions including oversight of internal operations and contracts, while advancing policies and procedures that improve org

This position is responsible for the assessment of behavioral and mental health needs in children birth through age five who display social/emotional and behavior problems. It provides mental health treatment, consultation, and recommendations to young children and their caregivers as well as referrals to other care providers. It emphasizes a high level of skill and knowl

and Accountabilities Provide care in a non judgmental, non discriminatory manner that is sensitive to the patient's developmental age and to the patient's and family's diversity, preserving their autonomy, dignity, and rights. Track and communicate pertinent medical and psychiatric information both verbally and through written documentation in EHR. Perform duties assigned