Job Description
We are so glad you are interested in joining Sutter Health!
Organization: CPMC-California Pacific Med Center Van Ness
Position Overview: Transplant: Responsible for insurance verification and eligibility, assessment of patient financial requirements, counseling patients on insurance benefits and co-payments. Obtains pre-authorization for all transplant services and collects clinical justification for submission. Works closely with department staff, physicians and practice staff to facilitate timely start and continuity of transplant services. Works in conjunction with managed care department for both facility & professional contracts for Transplant services. Has experience & knowledge of managed care contracting and plan types. This position ensures the organization and overall function of all processes required for the efficient tracking and authorization of transplant evaluations, transplant hospitalizations, and other admissions related to the patient's end-stage organ disease. This position is directly responsible for authorizing both Medical Center and Physician Services. Serves in a liaison capacity for third party payers regarding authorization status and any follow-up information required from the Transplant Program. Participates as Financial expert in the multidisciplinary team to select transplant candidates at weekly in-person committee meeting. Possess a comprehensive knowledge of federal regulations, legislation, and third party payor regulations regarding reimbursement. Excellent communication, organizational and interpersonal skills required. Must work independently and be able to work in a fast paced, hectic environment handling stress to meet deadlines and from interruptions. The ability to handle multiple conflicting priorities is required.
Job Description :
EDUCATION: HS Diploma or General Education Diploma (GED)
TYPICAL EXPERIENCE: 2 years of recent relevant experience.
SKILLS AND KNOWLEDGE: Verbal and written communication skills for high level contact with physicians, patients, contracting department, and insurance case management.
Organizational skills and critical thinking.
Ability to work with others in a flexible, cooperative manner.
Computer data entry skills to enter patient and authorization information.
Job Shift: Days
Schedule: Full Time
Shift Hours: 8
Days of the Week: Friday, Monday, Thursday, Tuesday, Wednesday
Weekend Requirements: None
Benefits: Yes
Unions: No
Position Status: Non-Exempt
Weekly Hours: 40
Employee Status: Regular
Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.
Pay Range is $38.20 to $47.74 / hour
The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package. Sutter Health
Job Tags
Full time, Flexible hours, Shift work, Weekend work,