Managed Care Liaison Consultant

Job Description

Job Description

Description :

Position Overview : Managed Care Liaison Consultant

A Managed Care Liaison Consultant is responsible for assisting our clients with complex issues that arise across the various steps of patient stays with the goals of ensuring that appropriate insurance coverage / approval is secured, and corresponding claims billed for services are processed and paid out accordingly. The Managed Care Liaison Consultant reports to the Director of Liaison Services.

Key Results Area

• Puts forth best efforts to learn and understand full training provided upon onboarding.
• Handles client outreach including patient coverage determination, prior auth resolution, claims resolution, carve-out obtainment, and consulting as related to managed care admissions and claims.
• Maintains a full caseload (approximately 40-50 tickets) while ensuring that each case is being addressed appropriately and timely.
• Respond to incoming client requests promptly within 3 business days while still prioritizing time-sensitive cases accordingly (within 24 hours).
• Responds to incoming client requests in a clear, professional, and courteous manner.
• Collaborates with other Liaison team members to ensure the best possible outcomes for our clients.
• Collaborates with other Guided Care teams for such enrolled clients as necessary to secure accurate case assessments.
• Participate in 1 : 1 meeting with the Supervisor monthly.
• Communicates respectfully with colleagues and leadership.
• Assists in handling additional cases during downtime or a lull in individual caseload.
• Other duties as assigned.
• Maintains attendance as scheduled, time clock check-ins, and takes PTO according to HR policies.
• Agree to uphold and practice company principles (GUIDE) in all work-related interactions.

Requirements : Requirements

Working Conditions / Physical Demands