Care Coordinator

Behavioral Health Services, Inc.-posted about 1 month ago
Full-time • Entry Level
Gardena, CA
101-250 employees
Ambulatory Health Care Services
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Under the direction of the Licensed Clinical Care Coordinator, the Care Coordinator initiates calls with potential patients and insurance companies, verifies insurance benefits for patients', performs utilization review and outreach to insurance companies to update and obtain private insurance contracts. The CC is a member of a multidisciplinary team; essential duties include but are not limited to: verification of benefits, insurance navigation and client advocacy with providers. Communicates in a professional manner, obtains accurate information and advises team and patient.

  • Verifies and confirm insurance coverage with insurance companies by diagnostic and procedural codes.
  • Provide a centralized contact point between BHS service providers, Insurance companies and patients.
  • Must have excellent written and verbal communication skills. Be familiar with insurance terminology, types of policies and insurance industry rules.
  • Responsible for reviewing patient's case and insurance coverage information and determine if there are any co-pays or other insurance requirements.
  • Be familiar with all patient treatment and provide information for Payor
  • Ensure timely processing of benefit information.
  • Participate in utilization review
  • Support billing reconciliation
  • Be an advocate for patients with providers.
  • Respond to treatment team and patient inquiries by phone and email.
  • Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
  • Knowledge of drug and alcohol dependency, mental health, family and systems.
  • Ability to demonstrate ethical and professional behavior.
  • Ability to convey respect for cultural and lifestyle diversities of clients and staff.
  • Basic knowledge of referrals, both inside and outside of the BHS treatment system.
  • Basic understanding of computer operations; Windows and word processing. Ability to readily adapt to the indicated automated information system.
  • Other duties may be assigned
  • Verify insurance benefits
  • Communicate with insurance companies, preauthorize admits and coordinate continued and/or extended care benefits.
  • Communicate and advocate patient care needs with insurance companies and BHS staff
  • Maintain record system of private insurance patients
  • Adhere to professional standards
  • Bachelor's Degree in a in health or human/social service or related field related field.
  • Certification as a chemical dependency counselor.
  • Minimum of five years working in substance abuse.
  • Knowledgeable of insurance benefits and medical terminology.
  • Must have valid California driver's license and liability insurance if driving personal vehicle on BHS business.
  • Vision, hearing, manual dexterity and eye-hand coordination must be adequate for performance of job duties.
  • Able to sit at desk, use keyboard, write and physically perform other job duties.
  • Able to move about the facility.
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