Mission Statement: It is our mission to improve the quality of life for the diverse communities of South Los Angeles and Southeast Los Angeles County by providing affordable and comprehensive health care and education in a welcoming and multi-cultural environment. We aim to lead the way in health care in South Los Angeles, as the premier provider and employer of choice offering comprehensive, high quality, affordable, efficient and culturally responsive services.
General Summary:
Responsible in maintaining the uniform standards for the medical front office operations throughout the organization including, but not limited to the following areas: front office protocol, managed care billing, estimation of benefits review, referrals, and pre-authorizations.
Summary of Essential Duties: (*Essential Functions)
- Standardization of medical front office procedures
- Assist Clinic Supervisor with front office work schedules
- Regular evaluates of medical front office processes/procedures.
- Training of medical front office staff to ensure standard practices and compliance
- Trains on Electronic Practice Management (EPM), Health Record (EHR), and Medical Record (EMR) Software for front office staff. Train of back-office staff, as necessary on EPM, EHR, and other front office software
- Generates of practice management reports to facilitate managed-care medical billing
- Review,organization,and filing of managed-care estimation of benefits statements. Investigation of denials and pended claims. Resubmission of denied and pended claims, as necessary. Communication with managed-care plans/representative to resolve claim denials or concerns
- Investigation and resubmission of denials
- Generates and submits of medical treatment pre-authorizations
- Reviews and action on approval and denials.
- Coordinates with providers and back-office staff that pre-authorizations are submitted when necessary
- Reviews of monthly managed-care rosters, submission of rosters to medical team members assigned to outreach, review of outreach results, and filing and organization of results
- PSR Coordinator will fulfill the responsibilities of the Medial Patient Service Representative position, including the responsibilities for registering and processing patients for appropriate appointments and services, including, but not limited to scheduling and canceling appointments; and verifying eligibility for specific programs and services
Job Specifications: (Knowledge, skills, abilities and experience normally required for competent performance)
Education and Knowledge
- High School Diploma or equivalent required
- AA Degree preferred
- Medical terminology, a plus
Experience
- Must have minimum 4+ years office experience, preferably in a medical clinic setting
- Vocational training in Office Administration, preferred
Skills and Abilities
- Excellent communication with superiors and peers
- Positive interaction with patients, visitors & staff
- Must have excellent phone, communication, and excellent customer service skills
- Bilingual/biliterate Spanish/English Required
- Must work well with constant interruptions and be a team player
- Multi-task and detail oriented
- Answers multi-line telephone, ensuring that all calls are channeled to, and responded by the appropriate personnel
TO APPLY PLEASE VISIT: https://recruiting.paylocity.com/recruiting/jobs/All/325da02f-904e-426b-ab73-f734fa9906c9/South-Central-Family-Health-Cent