Illumination Foundation
Authorization Coordinator
Illumination Foundation, Riverside, California, United States, 92504
“Every person deserves compassion, dignity, and the safety of a place to call home.”
Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care centers, emergency shelters, housing services and children's and family programs. IF currently has 13+ facilities with 22+ micro-communities scattered across Orange County, Los Angeles County and the Inland Empire.
Job Description
The Authorization Coordinator will be responsible for tracking and keeping up to date on the authorizations for the Recuperative care and STPH services from intake to exit. This role will need to communicate with Site Medical Staff, Site Manager, and Case Management, Director of Operations and Associate Director of Medical Billing. The authorization coordinator is also responsible for auditing client charts to confirm Managed MediCal enrollment, assist clients with MediCal redetermination or enrollment paperwork.
This role will be Tuesday/Thursday/Friday in Office, Monday Wednesday work from home.
The pay range for this role is: $26.00- $28.00 per hour.
Responsibilities:
CalAIM Authorizations and Benefits
Responsible for tracking and submitting initial and ongoing authorizations for Recuperative Care and Short-Term Post Hospitalization Services
Communicate with Medical Coordination Staff, Site Manager, and Case Management for client intake and exit updates
Collect all supporting documentation necessary to submit authorization request
Review monthly Calaim Recup and STPH Billing Report
Communicate in a timely matter when a client is not approved for services and proceed with appeal or escalate need for a quicker exit
Audit Illumination Foundation Calaim Recup/STPH client charts to confirm Managed MediCal benefits enrollment
Perform insurance entry clean ups as needed
Assist clients with MediCal recertification and enrollment and communicate with case management what is needed to help client complete application process
Escalate issues and/or disqualification with team
Demonstrate a strong understanding of MediCal and Managed MediCal
Demonstrate sufficient knowledge of Social Services Agency and Department of Public Social Services processes and collaborate with organizations as needed
Responsibilities subject to change upon company needs
Communicate with tact and professionalism
Be able to meet targets and work under pressure with a high volume of claims
Maintain knowledge of industry standard CMS guidelines for Billing
Must be motivated to work independently as well as in a group setting.
Fulfill Illumination Foundation’s Guiding Principles of Integrity, Humility, Sustainable Compassion, Quest for Knowledge and Critical Thinking, Client-Centered Care, Innovation, Advocacy, and Stewardship and Compliance.
Minimum Qualifications/Preferred Experience:
High School Diploma or equivalent.
1-2 years' relevant experience.
Basic computer skills, including the ability to send and receive emails and summarize data in spreadsheets.
Valid CA Driver’s License and eligibility for company vehicle insurance.
Prior experience work in Electronic Billing Platforms and EHR systems
Prior experience working with claims and communication with health networks
Benefits
Medical Insurance funded up to 91% by Illumination Foundation (Kaiser and Blue Shield), depending on the plan
Dental and Vision Insurance
Life, AD&D and LTD Insurance funded 100% by Illumination Foundation
Employee Assistance Program
Professional Development Reimbursement
401K with Company Matching
10 days holiday PTO/year
Paid vacation and sick days
Potential eligibility for the Public Service Loan Forgiveness Program (PSFL) for federally qualified loans
Proficiency in Microsoft (Mail, Docs, Sheets, Calendar).
Associate's degree or higher
Medical Billing Certificate
Experience in Medical Billing and Primary Care Billing
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Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care centers, emergency shelters, housing services and children's and family programs. IF currently has 13+ facilities with 22+ micro-communities scattered across Orange County, Los Angeles County and the Inland Empire.
Job Description
The Authorization Coordinator will be responsible for tracking and keeping up to date on the authorizations for the Recuperative care and STPH services from intake to exit. This role will need to communicate with Site Medical Staff, Site Manager, and Case Management, Director of Operations and Associate Director of Medical Billing. The authorization coordinator is also responsible for auditing client charts to confirm Managed MediCal enrollment, assist clients with MediCal redetermination or enrollment paperwork.
This role will be Tuesday/Thursday/Friday in Office, Monday Wednesday work from home.
The pay range for this role is: $26.00- $28.00 per hour.
Responsibilities:
CalAIM Authorizations and Benefits
Responsible for tracking and submitting initial and ongoing authorizations for Recuperative Care and Short-Term Post Hospitalization Services
Communicate with Medical Coordination Staff, Site Manager, and Case Management for client intake and exit updates
Collect all supporting documentation necessary to submit authorization request
Review monthly Calaim Recup and STPH Billing Report
Communicate in a timely matter when a client is not approved for services and proceed with appeal or escalate need for a quicker exit
Audit Illumination Foundation Calaim Recup/STPH client charts to confirm Managed MediCal benefits enrollment
Perform insurance entry clean ups as needed
Assist clients with MediCal recertification and enrollment and communicate with case management what is needed to help client complete application process
Escalate issues and/or disqualification with team
Demonstrate a strong understanding of MediCal and Managed MediCal
Demonstrate sufficient knowledge of Social Services Agency and Department of Public Social Services processes and collaborate with organizations as needed
Responsibilities subject to change upon company needs
Communicate with tact and professionalism
Be able to meet targets and work under pressure with a high volume of claims
Maintain knowledge of industry standard CMS guidelines for Billing
Must be motivated to work independently as well as in a group setting.
Fulfill Illumination Foundation’s Guiding Principles of Integrity, Humility, Sustainable Compassion, Quest for Knowledge and Critical Thinking, Client-Centered Care, Innovation, Advocacy, and Stewardship and Compliance.
Minimum Qualifications/Preferred Experience:
High School Diploma or equivalent.
1-2 years' relevant experience.
Basic computer skills, including the ability to send and receive emails and summarize data in spreadsheets.
Valid CA Driver’s License and eligibility for company vehicle insurance.
Prior experience work in Electronic Billing Platforms and EHR systems
Prior experience working with claims and communication with health networks
Benefits
Medical Insurance funded up to 91% by Illumination Foundation (Kaiser and Blue Shield), depending on the plan
Dental and Vision Insurance
Life, AD&D and LTD Insurance funded 100% by Illumination Foundation
Employee Assistance Program
Professional Development Reimbursement
401K with Company Matching
10 days holiday PTO/year
Paid vacation and sick days
Potential eligibility for the Public Service Loan Forgiveness Program (PSFL) for federally qualified loans
Proficiency in Microsoft (Mail, Docs, Sheets, Calendar).
Associate's degree or higher
Medical Billing Certificate
Experience in Medical Billing and Primary Care Billing
Powered by JazzHR