Managed Care Specialist

@ Ventra Health

Job Overview

Ventra Health is a leading business solutions provider for facility-based physicians practicing in areas such as anesthesia, emergency medicine, hospital medicine, pathology, and radiology. The Managed Care Specialist role focuses on Revenue Cycle Management by resolving contract variances, maintaining reporting requirements, and working with payers and internal teams to ensure accurate reimbursement.

Key Responsibilities

• Facilitate resolution of contract variances and discrepancies.
• Communicate with payers and internal teams regarding managed care projects.
• Maintain daily, weekly, and monthly reporting requirements.
• Conduct contract performance reviews and analyze accounts receivable.
• Provide training and managed care guidance to other departments.
• Manage non-par processes and perform special projects.

Education and Experience

High School Diploma or GED and at least three years of experience in medical billing are required.

Knowledge, Skills, And Abilities

• Understanding of State, Federal, and Managed Care regulatory guidelines.
• Knowledge in benefit insurance billing contract management.
• Excellent communication, decision-making, and problem-solving skills.
• Good time management and basic computer skills including word processing, spreadsheets, databases, and presentations.
• Ability to work with sensitive and confidential information in a collaborative, fast-paced environment.

Compensation & Benefits

This role is eligible for a performance-based incentive plan along with a robust Rewards & Recognition program and referral bonus opportunities.

Key skills/competency

• managed care
• contract management
• billing
• reporting
• regulatory
• communication
• analysis
• training
• problem-solving
• collaboration