Description We are seeking a Business Manager - Medical situated in Jacksonville, Florida, 32205, United States. This role involves providing financial and business office support, managing accounts payable, and assisting in daily claims processing. This role suits someone who can work collaboratively with a team and has a strong understanding of accounting and finance within the medical industry.Responsibilities: Develop and implement strategic plans to enhance claims processing efficiency and accuracy. Ensure the prompt and accurate processing of claims. Implement and maintain claims processing systems and workflows to streamline operations. Prepare authorizations for services as assigned. Collaborate with the finance department to reconcile claims and ensure accurate payment processing. Track and monitor incurred but not received reserves to ensure proper funding and processing of future claims. Review, obtain approval, and submit all required pharmacy data for analysis and quality review prior to submission to CMS for Part D monthly, quarterly, semi-annual, and annual reporting. Oversee the Medicare Part D bid process in coordination with actuaries and manage the Part D reserve model. Assist with the overall claim process and follow up with providers to ensure that claims processing is being completed as required. Review and validate the reports in PBM for required follow up and maintenance. Requirements Minimum of 2 years' experience as a Business Manager in the medical field. Proficiency in Accounting Software Systems. Experience with ADP - Financial Services. Proficiency in Customer Relationship Management (CRM). Familiarity with Database management. Knowledge of EO/IR systems. Experience with 'About Time' software. Proficiency in Accounting Functions. Experience with Accounts Payable (AP) and Accounts Receivable (AR). Understanding of Billing Functions. Knowledge of Health Care Audits - Medicare - Medicaid. Proficiency in GAAP Accounting. Experience dealing with Third Party Insurance Carriers and Third Party Payers. Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more.All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.© 2024 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (https://www.roberthalf.com/us/en/terms) .
