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
  • Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
  • Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

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.

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What This Job Offers

Job Type

Part-time

Education Level

High school or GED

Number of Employees

5,001-10,000 employees

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