Managed Care Correspondence Clerk in Santa Fe Springs, CA at Avanti Hospitals

Date Posted: 10/26/2020

Job Snapshot

Job Description

Central Business Office

Job Title: Managed Care Correspondence Clerk  

City: Santa Fe Springs / State: California    

Central Business Office

Day Shift

From 8:00 AM

To 4:30 PM

                                      


Job Description and Job Responsibilites

Job Title: MANAGED CARE CORRESPONDENCE CLERK

Job Summary:  Responsible for working all Correspondence regarding Managed Care accounts in a professional and timely manner. Works with Collectors and Billers to ensure payors are receiving any requested information. Must be able to multi-task and have knowledge in collections.

 

Reports To: Managed Care Manager, and or CBO Director

Essential Job Duties:  

  • Follows up on all correspondence requiring action in a timely manner, including phone calls to payors and patients.
  • Document all patient accounts regarding action taken on correspondence received.
  • Retrieves Patient records from the HBF system as needed.
  • Ensures re-bills to payors are sent timely.
  • Update and or correct Plan ID’s in a timely manner.
  • Work closely with Managed Care Collectors.
  • Handle vendors request for information regarding Managed Care accounts.
  • Prepare and submit adjustments as needed.
  • Check website or make appropriate phone calls for eligibility as needed.
  • Mails follow-up letters to patients/ insurance companies in a timely manner.
  • Handles all clients in a courteous and professional manner.
  • Refers EOB’s to biller for secondary insurance billing is applicable.
  • Demonstrates the ability to recognize and deal with priorities in order to complete work in a timely manner.
  • Performs all other duties and projects as assigned.

Behavioral Standards: 

  • Exhibits customer and service oriented behaviors in every day work interactions.
  • Demonstrates a courteous and respectful attitude to internal workforce and external customers.
  • Communicates accurately and appropriately.
  • Works well and efficiently under minimal supervision.
  • Handles difficult situations in a discreet and professional manner.
  • Is adaptable to changes in assignments and priorities.

Communication/Knowledge:

  • Provides accurate and timely written and verbal communication of information in a manner that is understood by all.  
  • Able to listen, understand, problem-solve, and carry-out duties to ensure the optimal outcome.
  • Able to use IT systems in an accurate and proficient manner.

Collaboration/Teamwork:

  • Contributes toward effective, positive working relationships with internal and external colleagues.
  • Demonstrates cooperation, flexibility, reliability, and dependability in all daily work activities and a willingness to collaborate with others for the good of the customer and the organization. 

Job Requirements

Education/Experience:

  • High school graduate or equivalent required
  • At least 2 years of current experience in an acute care hospital setting preferred.
  • Some knowledge in collections
  • Computer skills preferred

Licensure/Certifications:

  • N/A

ADA/Physical Demands:

  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed are representative of the knowledge, skill, and/or ability required.  Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Such accommodations must be requested by the employee/applicant in order to be considered.
  • Required to stand; walk; sit; use hands to fingers, handle, or feel; reach with hands and arms; stoop, kneel, crouch, or crawl; talk and hear; and may taste and smell.  The employee is regularly required to lift, push and/or pull weights in excess of 10 pounds, with assistance. Visual abilities, auditory abilities, must be intact to perform duties.