Providence Health & Services PPO Request Specialist - Utilization Management in Mission Hills, California
Providence is calling a ( Full Time /Day Shift ) PPO Request Specialist to our Facey Utilization Management location in Mission Hills, CA.
In this position you will:
Demonstrate competency and knowledge in HMO/EPO/PPO eligibility and benefit coverages.
Serve as a liaison between patients, hospitals, health plans, and Facey Medical Foundation and Facey Medical Group.
Be responsible for verification of eligibility and benefits for managed care members.
Required qualifications for this position include:
One to two years of experience in a clinic, hospital or related health care industry in a managed care environment or equivalent in education or medical certification in medical field (i.e. nursing, medical billing and coding, or medical administrative assistant).
Knowledge of HMO/EPO/PPO insurance processing, ICD-9 and 10/CPT coding and medical terminology a plus.
Ability to use 10-key calculator by touch or sight.
Type 45 wpm, computer skills (MS Office Word, Excel, Outlook) and data entry experience required.
Ability to multi-task and prioritize.
Must possess excellent customer service and communication skills, answer customer service call line.
Must be organized and a self-starter.
About the organization you will serve:
Facey Medical Group is a multi-specialty medical group with over 160 physicians providing care to the growing population in the North & East regions of Los Angeles & Ventura Counties. Twelve medical clinics, including two urgent care centers and dedicated women's centers, are located across the San Fernando, Santa Clarita, San Gabriel and Simi Valleys. The group began as a single medical practice over 90 years ago.
Facey is part of Providence Health & Services, an integrated, not-for-profit 5-state network of hospitals, care centers, medical clinics, affiliated services and educational facilities spanning from California to Alaska .
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. 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.
Job Category: Administrative (Clinical)
Location: California-Mission Hills
Req ID: 236056