Care Coordination 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 is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care.

It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do - in the health of our patients, our loved ones, and our community.

Benefits Eligible

Full-Time Benefit Eligible

Work Shift Variable - 8 Hour or less Shift (United States of America)

Department 8590 Precert/Benefits Verification

Ensures that all hospitalizations are communicated to the appropriate payer source in a timely manner.

QUALIFICATIONS

Education Preferred: High School diploma or equivalent

Experience Preferred: Previous experience with health insurance guidelines.

Knowledge/Skills/Abilities Ability to multi-task.

JOB RESPONSIBILITIES

Essential

• Works with Case Managers on various floors and campuses to communicate about patient cases and changes to level of care.
• Knowledgeable on various insurance payers' rules and guidelines including Medicare and Medi-Cal.
• Notifies appropriate payer source in a timely manner of patient's stay. Communicates any issues with Supervisor.
• Identifies trends or issues with registration quality and communicates with appropriate members of Leadership.
• Able to multi-task and work on numerous accounts if on hold for a long duration of time with insurance companies.
• Tracks and trends payer issues. Attends payer meetings if scheduled and communicates issues.
• Identifies patients who are uninsured or underinsured. Works with Financial Counselors whenever applicable.
• Collaborates as a team to ensure all items are worked on in a timely manner. Understands that all incomplete tasks can result in a negative financial impact to the Kaweah Health.

Additional

• Quality checks and scans own work into EDM.
• Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served on the assigned unit or work area.
• Performs other duties as assigned.

Pay Range

$22.48 -$33.72

If you want to use your talents alongside people who face each day with courage and purpose, in an environment that empowers you to do your absolute best, this is where you belong.