Care Connection Associate Full-time, Day Shift

Adventist Health • Simi Valley, CA

1d

About The Position

Centered in beautiful Southern California, Adventist Health Simi Valley has been
one of the area's leading healthcare providers since 1965. We are comprised of a
144-bed hospital, home care services and a vast scope of award-winning services
located throughout Ventura County. Simi Valley is a suburban area nestled
between an urban oasis and the stunning shores of the Pacific Ocean. Bordering
Los Angeles allows hiking in the morning and attending film premieres in the
evening.

Job Summary:

Manages incoming and outgoing referrals from Imaging, primary and specialty
providers in a timely and professional manner; schedules appointments according
to practice policy; maintains positive relations with referral sources;
schedules appointments from third party electronic referral systems, fax, email
and web requests; and participates in marketing to referring practices. Provides
quality customer service & patient financial responsibilities to patients,
referring physicians, visitors and internal customers by obtaining insurance
authorization and benefit verification for imaging procedures and specialty
referrals.

Requirements

• High School Education/GED or equivalent: Preferred

Nice To Haves

• Associate’s/Technical Degree or equivalent combination of education/related experience: Preferred

Responsibilities

• Processes inbound and outbound referrals, verifies referrals are correctly ordered according to protocols in the EHR. Obtains benefit verification and necessary authorizations (referrals, pre-certification) prior to patient arrival for all ambulatory visits, procedures, injections and radiology services.
• Uses online, web-based verification systems and reviews real-time eligibility responses to ensure accuracy of insurance eligibility. Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
• Serves as navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns. Occasionally assumes advocate role on the patient’s behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion. Assists patient in problem-solving potential issues related to the healthcare system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance)
• Maintains satisfactory productivity rates and ensures the timeliness of referral and scheduling while maintaining work queue goals.
• Collaborates effectively with Care Connection Center associates and responds to provider (internal and external) and support staff questions, requests and concerns regarding the status of patient referrals, care coordination or follow-up status.
• Performs other job-related duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED