Bed Control Coordinator II - PHMI Other Ancillary Svc (SFMC)
About The Position
Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation’s leading health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team! Under supervision from the clinical care team, provides care coordination for patients as they move into and through the care continuum. Primary responsibilities include providing utilization review function for direct admit patients, patient requiring repatriation, patient in out-of-network setting and providing clinical information to Chief Medical Officers for final determination. Ensures accurate, timely processing of insurance verifications, patient registration, timely notification of payor to ensure maximum reimbursement, facilitating benefit coverage for continuum of care needs, ensuring the flow of information to continuum care providers, and maintaining a high level of confidentiality.
Requirements
- Must have clinical and patient care experience.
- Must possess excellent spelling and grammar skills.
- Ability to manage and prioritize multiple activities in a fast-paced environment.
- Works in the department as needed in designated areas.
- Ability to handle stressful situations with physicians and ancillary departments.
- Must be detail-oriented and have a high degree of organizational skills.
- Must have experience working with computers and computer software/applications.
Nice To Haves
- Associates degree or higher degree preferred.
- Previous insurance background preferred.
- Previous experience with Insurance UR preferred.
Responsibilities
- Provides care coordination for patients as they move into and through the care continuum.
- Provides utilization review function for direct admit patients, patient requiring repatriation, patient in out-of-network setting
- Provides clinical information to Chief Medical Officers for final determination.
- Ensures accurate, timely processing of insurance verifications and patient registration
- Provides timely notification of payor to ensure maximum reimbursement
- Facilitates benefit coverage for continuum of care needs
- Ensures the flow of information to continuum care providers
- Maintains a high level of confidentiality.
Benefits
- paid time off
- a 401K retirement plan
- medical, dental, and vision coverage
- tuition reimbursement
- many more voluntary benefit options
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
