Sr. Customer Care Associate, Home Health, Bakersfield

Adventist Health • Bakersfield, CA

5d

About The Position

Our home health and hospice agencies are located throughout California, Hawaii, Oregon and Washington. They serve the entire community and offer personalized in-home care, and many have been recipients of Home Care Elite awards. So whether you're looking for the buzz of a large city, the tranquility of nearby mountain bike trails or something in between, we encourage you to explore our organization. Job Summary: Provides day-to-day administrative support for the Home Health patients and department.

Requirements

• High School Education/GED or equivalent: Preferred
• Two years' relevant experience: Preferred

Nice To Haves

• Associate's/Technical Degree or equivalent combination of education/related experience: Preferred

Responsibilities

• Handles incoming calls from plan members and healthcare providers for the assigned health plans.
• Provides information as needed for questions related to medical, dental, vision, and prescription drug claims based upon the benefit descriptions and plan provisions of a variety of group plans.
• Documents all calls.
• Receives referrals and pre-certification requests from providers as applicable.
• Reviews referral/pre-certifications for proper benefits and eligibility.
• Enters referrals and pre-certifications data into the computer system.
• Reviews referrals and medical record information as applicable to facilitate claims department with claims adjudication.
• Researches and documents rejected or erroneous claims and forwards them for correction as needed.
• Performs other job-related duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees