Overview:Come join an innovative leader in the healthcare industry! MDVIP, based in Boca Raton, FL is seeking an* Associate Director of Insurance Services.* This role will lead, motivate, and direct the Insurance Services team to provide comprehensive consultative support and guidance regarding the payer organizations to physicians, physician’s staff, patients, and internal employees. Additionally, the Associate Director will liaise with managed care organizations, insurance companies, governmental payers, physicians and vendors to ensure consistent application of processes and exceptional customer service, as well as lead insurance related projects to support the network.

MDVIP has consistently been recognized as a Great Place to Work® employer since 2018. (Greatplacetowork.com/certified-company/MDVIP) and was named by Fortune and Great Place to Work® as one of the 2021 Best Workplaces in Healthcare & Biopharma™. This is a corporate based role. This role may be eligible for a hybrid in office/work from home schedule based on department needs after 90 days of employment.
Responsibilities:

• Provide consultative services to manage all insurance interactions with and/or on behalf of MDVIP or physicians.
• Oversee teams to provide insurance specific expertise by analyzing various components of the physician/practice needs and provides appropriate guidance to the interdepartmental management teams to help ensure successful outcomes.
• Oversee all aspects of implementation processes as it relates to the areas of insurance services. Including identification of insurance companies contracted by physician, payer mix and coordination of all communications on behalf of physician or MDVIP relative to the insurance contracts.
• Provide guidance to physicians/staff on re-credentialing and Medicare notification/enrollment during practice changes, ie; new tax ID, relocation, etc.

• Own, monitor, audit, and perform remediation activities specific to insurance data elements such as in-network status, for prospect and affiliated physicians throughout their lifecycle and across business processes.

• Direct teams to provide insurance specific recommendations to financial analysts based on prospect insurance data analysis. May represent the team in the ARC meetings and provide information on the insurance analysis.
• Provide guidance and consultative support to management, coordinators, insurers, physicians, and staff as related to MDVIP Program and insurance related matters. Review insurance contractual language, including contracts, appeals, and addendums.
• Ensure the review of state level insurance report and makes recommendations to leadership regarding noted trends.
• Oversee communication with insurance companies on behalf of physicians and/or patients when applicable. Responsible for handling insurance company appeals and attending hearings, as requested by the affiliate(s).
• Oversee representation of the department in virtual and onsite corporate visits. Analyze insurance and practice specific information to create and conduct physician training presentations for the physician’s corporate visit.

• Provide guidance to the network regarding coding practices. Responsible for understanding coding changes and communicating such within the network, as needed.
• Provide guidance to the sales team on network insurance matters and supports TPC's
• Oversee the management of the MDVIP Malpractice program including the coordination and maintenance of malpractice insurance vendors, as well as the enrollment process for MDVIP affiliates.

This job profile is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time with or without notice.
Qualifications:Education / Experience / Knowledge:
Bachelor's degree from four-year college or university and 2 years of experience working in insurance industry or similar setting; or equivalent combination of education and required experience where two years’ experience qualifies for one year of schooling.
In place of a Bachelor’s degree, eight years specific experience in an insurance company or similar setting analyzing insurance contracts, and/or billing/claims operations. Knowledgeable about insurance claim processing, revenue cycle management.

• Fully knowledgeable about insurance claim processing, revenue cycle management.
• Contract and credentialing management as well as knowledge of malpractice liability insurance requirements.

Certificates and Licenses:
No certifications required.
Preferred Certificates:

• CCS (Certified Credentialing Specialist),
• Billing and Coding certifications, and;
• Revenue Cycle Management certification

Corporate office role: As a corporate based role in Boca Raton, FL, employees are expected to work from the corporate office. This role may be eligible for a hybrid in office/work from home schedule based on department needs after 90 days of employment.

Additional information:
At no time may work be performed, or computer systems accessed, from outside of the U.S.
Individuals hired must be able to perform essential duties satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
MDVIP provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Consistent with our mission, purpose, and core values, MDVIP takes the health and safety of its employees very seriously. With the concern over the spread of the coronavirus or “COVID-19,”and its variants, MDVIP has, and will continue to take reasonable measures to mitigate the potential spread of COVID-19. Your recruiter will provide more information during the interview process.

Location: 4950 Communication Avenue,Suite 100, Boca Raton, FL 33431

Job Type: Full-time

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