Managed Care Specialist in North Kansas City, Missouri at North Kansas City Hospital

SUMMARY: SUMMARY: Under the direction of the Managed Care Coordinator, the Managed Care Specialist is responsible for helping ensure the financial health of North Kansas City Hospital NKCH and Meritas Health through support of enterprise managed care activities. Position will require an understanding of healthcare reimbursement for hospitals and medical groups, contract negotiation concepts, and functionality of payor websites and other technology within managed care workflows. Participates in denials management and reimbursement issue reviews. Organizes meetings with internal stakeholders and payor representatives, and collaborates with designated managed care vendors (mailers, underpayments, etc). Works closely with revenue cycle, accounting, decision support, and credentialing teams at NKCH and Meritas. Cognitive skills required for this position include: learning, remembering, focusing, categorizing, and reasoning.

EXPERIENCE: Minimum of 3 years in managed care contracting, insurance industry, healthcare revenue cycle, provider credentialing, interpreting healthcare financial data, or other related experience required.

SPECIAL SKILLS: Advanced skills in Microsoft Excel, Word, OneNote, Teams; knowledge of medical terminology, UB-04, CMS-1500, and modifiers preferred. Experience with Cerner Patient Accounting preferred. Ability to confidently navigate department hardware/software as well as enterprise health record and applicable billing andpayment system modules.

OTHER: Excellent organization and attention to detail required; ability to communicate complex information to various audiences; ability to work in fast-paced environment; ability to problem solve issues where analysis is required; decisions and actions have direct impact on hospital financials; ability to work independently, and as part of a team. Ability to multi-task and prioritize multiple tasks to meet deadlines.

EDUCATION: Required: High School or Equivalent, Preferred: Associates - Related Field, Bachelors - Related Field