Managed Care Representative


Plymouth, MA

What you'll be doing

The managed care representative is responsible for processing patient insurance referrals, consultations and diagnostic procedures relating to patient care which includes knowledge of insurance companies and their covered services. In addition, the managed care representative will act as a patient navigator, contacting patients to provide appointment dates and times as well as any necessary testing needs and transportation information. Schedule appointments; follow up calls and documentation of appointments; reschedule appointments as necessary. Receive and process referrals according to protocol. Ensure that insurances are current and cross-referencing services covered; prior authorizations; liaison with internal and external business partners to ensure referrals are appropriately implemented. Provide technical assistance to other center staff as necessary.

What your background should be

2 years of experience working in a professional healthcare environment. Excellent verbal and written communication skills, problem solving skills. Intermediate computer literacy in Microsoft Office applications including Word, Outlook and Excel. Excellent skills in searching web browsers, knowledge of multiple on-line registration applications and use. Excellent office machinery skills; faxing, scanning, copying; phone system. Excellent customer service skills, experience using electronic medical records, electronic practice management, knowledge of medical terminology. Ability to work independently and as part of a team. Bilingual English or Spanish or Portuguese preferred.

Required Schooling / Training

High school diploma or GED.

Who is the client company

This is a non-profit, public health agency committed to providing quality, comprehensive health care services.
If you are interested in this position, send your resume to