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Job Description
Join Brickyard Healthcare as a Managed Care Specialist (RN or LPN) to provide essential case management for our healthcare clients. This role offers competitive pay and excellent health benefits, along with opportunities for career advancement in a supportive environment.
Key Responsibilities
Communicates care plan to insurance case managers with emphasis on strong discharge planning
Acts as liaison between Living Center/Agency and insurance plan to ensure proper payment for services
Communicates insurance benefits to all levels of associates
Understands provisions of contracts and associated exclusions
Works closely with facility and external support staff for negotiation of services and rates
Consults on appeals, retro authorizations and collections issues
Manages a live spreadsheet to reflect changes in authorizations and continued stay reviews
Initiates and updates facility and external staff on status of Authorizations
Works with insurance companies to ensure timely sharing of discharge disposition and documents
Prepares and submits insurance continued stay requests daily
Navigates insurance signing and return of NOMNC between insurance and facility staff
Maintains copies of authorizations in member folders and PCC documents
Submits requests for cost out of high-cost drugs with prior authorizations and concurrent reviews
Required Qualifications
Licensed as a Registered Nurse (RN) or Licensed Practical Nurse (LPN)
Minimum 2 years’ experience with insurance providers preferred
Minimum 2 years' experience in a long-term care setting preferred
Must be capable of maintaining regular attendance
Benefits & Perks
Competitive PayExcellent health benefits packagesCareer advancement opportunitiesEducation reimbursement program of up to $7,500 per yearFlexible scheduling availableNo waiting period for enrollmentThree health plan optionsDelta DentalVSP VisionFree Basic Life InsuranceDisability, Critical Illness, Accident & Legal Coverage401(k) Retirement PlanEmployee Assistance Program