Job Description

Hours:

Shift Start Time: 8 AM

Shift End Time: 4:30 PM

AWS Hours Requirement: 8/40 - 8 Hour Shift

Weekend Requirements: As Needed

On-Call Required: No

Hourly Pay Range (Minimum - Midpoint - Maximum): $30.010 - $37.510 - $45.010

This position is covered by a Collective Bargaining Agreement (CBA) with SEIU-UHW. As part of the terms of employment, employees in this role are required to join the union within 31 days of hire and remain a member for the duration of the collective bargaining agreement.

What You Will Do

This position supports case management/social work staff to meet department objectives, facilitating effective communication between department staff and internal and external customers, including the business office, revenue cycle, payors, long term care, sub-acute facilities, and patients/families. This includes reviewing complex requests for medical care and services, providing support for care coordination services, and managing the specific hospital's care and services.

Required Qualifications

• H.S. Diploma or Equivalent

Preferred Qualifications

• Additional health related education
• Successful completion of Medical Assistant Program or equivalent
• 2 Years hospital experience
• 2 Years Medi-Cal experience

Essential Functions

• Collaboration of Clinical Resources: Prepares inpatient census, verifies insurance eligibility, prepares paperwork for hospital case managers, and contributes to continuous improvement initiatives.
• Database Management: Processes letters of appeal or denial, shares patient access lists, and prepares databases and reports.
• Department Operations: Ensures staff have resources to optimize payer reimbursement, monitors patient authorizations, and maintains community agency communications.
• Discharge and Patient Follow Up: Confirms discharges, prepares discharge paperwork, and facilitates patient information transfer to facilities.
• Industry Skills and Competency: Obtains benefit coverage, reviews prior authorizations, and assists in the denial process.
• Patient Placement: Manages post-acute placements, coordinates with agencies and facilities, and handles patient prescriptions.
• Professional Development: Participates in training and quality improvement activities.

Knowledge, Skills, and Abilities

• Bilingual preferred
• Knowledge of hospital payors
• Proficiency in Microsoft Office
• Excellent organizational and communication skills
• Ability to work independently

Sharp HealthCare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, or disability status.

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