Care Coordination & Payer Verification Specialist

Kaweah Delta Health Care District; Visalia (CA); On-site; USD 31,000 - 46,000; Full time

Benefits offered by this job

Benefits Eligible

Full-Time Benefit Eligible

Job summary

Kaweah Health in Visalia, California is seeking a Precert/Benefits Verification specialist to ensure hospitalizations are communicated to the correct payer source in a timely manner. This full-time role falls under the Precert/Benefits Verification department and involves collaborating with Case Managers and Financial Counselors to verify insurance details and eligibility.

Responsibilities include handling Medicare/Medi-Cal payer rules, notifying payers promptly, and identifying trends in

Qualifications

• High School diploma or equivalent required.
• Previous experience with health insurance guidelines preferred.
• Ability to multi-task.

Responsibilities

• Coordinate with Case Managers on patient cases and changes to level of care.
• Know payer rules/guidelines for Medicare/Medi-Cal and communicate issues promptly.
• Notify payer sources in a timely manner about patient stays; escalate as needed.
• Identify trends in registration quality and communicate with Leadership.
• Manage multiple accounts if on hold with insurance companies; maintain accuracy.
• Track payer issues and participate in payer meetings; collaborate with Financial Counselors.

Skills

Multi-tasking

Education

High School diploma

Job description

Kaweah Health in Visalia, California is seeking a Precert/Benefits Verification specialist to ensure hospitalizations are communicated to the correct payer source in a timely manner. This full-time role falls under the Precert/Benefits Verification department and involves collaborating with Case Managers and Financial Counselors to verify insurance details and eligibility.

Responsibilities include handling Medicare/Medi-Cal payer rules, notifying payers promptly, and identifying trends in