Managed Care Specialist Salary
Most Managed Care Specialists in the United States are women. The median pay for people in this role is approximately $49K per year. Most Managed Care Specialists like their work and job satisfaction is high. A large number enjoy medical while a fair number get dental coverage. Vision coverage is also available to a strong majority. Figures cited in this summary are based on replies to PayScale's salary questionnaire.
Job Description for Managed Care Specialist
Managed care specialists generally work in the healthcare industry to verify insurance coverage; they may work directly with patients. These professionals refer patients to specialists, keep track of referral status, and obtain authorization on behalf of patients from managed care organizations. Other tasks performed by managed care specialists include working with patients' physicians to clarify specialist referrals, as well as performing a liaison function among the insurance company, customer operations staff, patient billing staff and other relevant professionals. These specialists address patients’ concerns regarding health insurance coverage, explain benefits to patients and may be involved in sales efforts.Read More...
Managed care specialists must follow their employer's guidelines, policies and procedures at all times. They may be required to attend training classes and workshops relevant to their job, as well as train and coach new specialists. Managed care specialists must know the differences among different types of healthcare plans such as HMOs, PPOs and EPOs, as well as be familiar with insurance codes relevant to patient billing.
Employers generally require that candidates for managed care specialist positions have at least high school diploma or equivalent. Companies may be willing to train employees to become managed care specialists, but they often prefer candidates with previous experience in the position. Managed care specialists must be able to work in a team environment, have basic computer skills, have excellent interpersonal and communications skills, and be able to work effectively and efficiently with patients.
Managed Care Specialist Tasks
- Review and audit managed care program to ensure professional standards.
- Resolve patient complaints regarding claims and services rendered.
- Collect and analyze data on managed care demographics, preferences and needs to identify potential contracts.
- Answer patient questions regarding the managed care program and policies.
- Coordinate marketing activities and policies to promote and educate managed care organizations.
Managed Care Specialist Job Listings
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Pay by Experience Level for Managed Care Specialist
Median of all compensation (including tips, bonus, and overtime) by years of experience.
The average inexperienced worker's salary is approximately $40K. It's worth noting that people with five to 10 years of experience report bringing in less at around $40K on average. After working for 10 to 20 years, Managed Care Specialists make a median salary of $45K. Managed Care Specialists who have acquired more than 20 years of relevant experience earn significantly more than folks with fewer years on their resumes; the average income in this veteran group is $55K.