Sr Clerk - Dignity Health
Woodland, CA
About the Job
Overview
Dignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California Arizona and Nevada. Today Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers we provide increasing support and investment in the latest technologies finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled qualities that are vital to maintaining excellence in care and service.
Responsibilities
Position Summary:
Under direct supervision, is responsible for a variety of duties which would initially start in an entry level of responsibility and eventually include training and skill in all appropriate areas of Case Management.
Responsibilities may include:
- Processes verification of eligibility.
- Data entry, authorizaitons and out-of-area referrals.
- Manages telephone calls and addresses questions from providers, families, patients and health plans.
- Assist UM Specialist in the prior authorization process, including contracting referring physicians when additional information is needed.
- Processes auto-approve referrals.
- Ensures that authorization letters are mailed in a timely manner.
- Maintains denial, appeal and CCS logs.
- Assist UM in education of Woodland Clinic Medical Group and other physician office staff on the authorization process and IDX.
- Provides coverage for UM Assistant.
Qualifications
Minimum Qualifications:
- 2 years related work experience, preferably in health insurance filed (HMO experience) which has provided the required knowledge and skills
- Equivalent of four years of high school
- Must be familiar with medical terminology ICD-9 and CPT coding
- Knowledge of insurance carriers and contractual agreements effective customer relations telephone etiquette computer operations common office equirment organization and operation of billing office standard alphabetic and numeric keyboards
- Ability to understand and follow oral and written instructions learn understand and follow rules policies and procedures deal tactfully and effectively with staff patients providers/physicians 3rd party payors and outside contacts in the course of work
- Ability to communicate information clearly and accurately to concentrate and attend to detail while working with speed and accuracy to operate a 1--key adding machine make accurate arithmetic computations and comparisons to research and evaluate account activity to determine action/corrections and to maintain confidentiality of patinet data and medical records
*This position is represented by SEIU-UHW
Pay Range**
$24.21 - $27.32 /hour
We are an equal opportunity/affirmative action employer.
Dignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California Arizona and Nevada. Today Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers we provide increasing support and investment in the latest technologies finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled qualities that are vital to maintaining excellence in care and service.
Responsibilities
Position Summary:
Under direct supervision, is responsible for a variety of duties which would initially start in an entry level of responsibility and eventually include training and skill in all appropriate areas of Case Management.
Responsibilities may include:
- Processes verification of eligibility.
- Data entry, authorizaitons and out-of-area referrals.
- Manages telephone calls and addresses questions from providers, families, patients and health plans.
- Assist UM Specialist in the prior authorization process, including contracting referring physicians when additional information is needed.
- Processes auto-approve referrals.
- Ensures that authorization letters are mailed in a timely manner.
- Maintains denial, appeal and CCS logs.
- Assist UM in education of Woodland Clinic Medical Group and other physician office staff on the authorization process and IDX.
- Provides coverage for UM Assistant.
Qualifications
Minimum Qualifications:
- 2 years related work experience, preferably in health insurance filed (HMO experience) which has provided the required knowledge and skills
- Equivalent of four years of high school
- Must be familiar with medical terminology ICD-9 and CPT coding
- Knowledge of insurance carriers and contractual agreements effective customer relations telephone etiquette computer operations common office equirment organization and operation of billing office standard alphabetic and numeric keyboards
- Ability to understand and follow oral and written instructions learn understand and follow rules policies and procedures deal tactfully and effectively with staff patients providers/physicians 3rd party payors and outside contacts in the course of work
- Ability to communicate information clearly and accurately to concentrate and attend to detail while working with speed and accuracy to operate a 1--key adding machine make accurate arithmetic computations and comparisons to research and evaluate account activity to determine action/corrections and to maintain confidentiality of patinet data and medical records
*This position is represented by SEIU-UHW
Pay Range**
$24.21 - $27.32 /hour
We are an equal opportunity/affirmative action employer.
Source : Dignity Health
