Providence is calling a Request Specialist ( Full Time / Day Shift ) at our Providence Medical Institute Managed Care location in Mission Hills, CA.
In this position you will:
Handles day to day activities of the Managed Care Department and patients.
Processes patient referral requests to specialist providers and coordinates patient care.
Verifies eligibility of managed care patients.
Serves as a liaison between physician, patient and health plan.
Verifies current contractual status of referral specialist.
Required qualifications for this position include:
Two years of experience in managed care. Knowledge of medical terminology, CPT, ICD 9, Medical Federal Register, DME, etc.
Knowledge of clinic charging, billing and registration policies and procedures.
Knowledge of HMO billing procedures.
Knowledge of clinic departments and operational relationships.
Skill in defining problems, collecting data, interpreting billing information.
Skill in computer applications.
Ability to perform mathematical computations and to compute ratios and percentages.
Preferred qualifications for this position include:
College experience in business courses related to medical management.
About the location you will serve:
Providence Health & Services Southern California is further developing its physician integration strategy. Historically, the largest asset has been Providence Medical Institute, a medical foundation that provides administrative and other support services to affiliated medical groups. Providence Medical Institute is expected to grow significantly in the next several years, bringing with it facilities, staff and physician growth to support that objective.
We offer a full comprehensive range of benefits - see our website for details
As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.
Providence Health & Services is the third largest not-for-profit health system in the United States. Providence employs more than 82,000 caregivers (employees) across a five-state area; AK, WA, MT, OR, and CA. Our facilities include 34 hospitals, 600 physician clinics, senior services, supportive housing and other health and educational services. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.