TEXASCONNECT INC
Case Manager-Denials/Appeals
Company Description
Texas Connect, Inc. (TCI) is a Management Services Organization (MSO). As an MSO, we are dedicated to providing business and administrative services for healthcare providers, such as medical practices and hospital systems, allowing them to focus on patient care. TCI handles crucial backend functions, such as Information Technology, Billing, and Medical Coding. This allows our client healthcare organizations to delegate these and other essential, but non-medical tasks to TCI to improve operational efficiency. https://www.texasconnectinc.com
Job Description
We have 8 openings. This position supports denials, appeals and compliance activities within the Care Management Department, including patient chart review, writing appeal letters and various audits supporting the Department and hospital in meeting regulatory requirements associated with Care Management.
Requirements
SPECIFIC SKILLS NEEDED: Excellent verbal, written, and organizational skills required Ability to follow chain of command Knowledge of medical terminology and current third party payor reimbursement methodologies Selfmotivated and results oriented. Must be able to demonstrate sound decision making and prioritization skills, utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant others when administering or explaining care. EDUCATION/EXPERIENCE/TRAINING Required: Maintain an active California LVN license Minimum of 2 years acute hospital experience Proficiency with mainframe and personal computers Preferred: Maintain an active California RN license. Managed care and case management experience
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