Care Coordination Specialist

Kaweah Delta Health Care District•Visalia, CA

15h

About The Position

Kaweah Health is a publicly owned community healthcare organization serving the greater Visalia area in central California. The Care Coordination Specialist works in the Precert/Benefits Verification department and ensures hospitalizations are communicated to the appropriate payer source in a timely manner. The role works with Case Managers across floors and campuses, tracks payer issues, and helps identify uninsured or underinsured patients. The position is full-time and benefit eligible, with a variable shift of eight hours or less.

Requirements

High school diploma or equivalent preferred.
Previous experience with health insurance guidelines preferred.
Ability to multitask.

Nice To Haves

Previous experience with health insurance guidelines.

Responsibilities

Work with Case Managers on various floors and campuses to communicate about patient cases and changes to level of care.
Apply knowledge of insurance payers’ rules and guidelines, including Medicare and Medi-Cal.
Notify the appropriate payer source of a patient’s stay in a timely manner.
Communicate issues to the Supervisor.
Identify trends or issues with registration quality and communicate them to appropriate members of Leadership.
Multitask and work on multiple accounts when waiting for insurance companies.
Track and trend payer issues.
Attend payer meetings when scheduled and communicate issues.
Identify uninsured or underinsured patients.
Work with Financial Counselors when applicable.
Collaborate with the team to ensure work is completed in a timely manner.
Perform quality checks and scan own work into EDM.
Provide care and services appropriate to the population served on the assigned unit or work area.
Perform other duties as assigned.