to verify insurance coverage, obtain proper authorizations, and ensure timely reimbursement of services. He/she reviews physician orders for medical necessity and accuracy and provides clinical documentation to support proper authorization. Accurately and timely codes insurance in the billing system.
Provides patient education of service of benefits, status of pending or denied authorizations, and gets assistance in resolving. Determines copayment and deductible amounts, maintains charge entry, and reconciles daily charges. Accurately enters insurance benefits and authorization information into patient accounts. Seeks assistance as needed to maintain service levels. May arrange for peer-to-peer
evaluations between physician offices and insurance companies as requested. Performs other duties as assigned. Additionally, the Insurance Verification Specialist III handles more complex accounts and higher volumes.
Tightly monitors day-to-day inventory to ensure insurance authorizations are in place before services are rendered. Maintains productivity expectations with low error rates. Verifies that scheduled services match with the Physician orders on file. Interprets medical policies and Local Coverage Determination (LCDs) to determine coverage requirements and to facilitate proper authorizations. Works all STAT requests within 48 hours. Serves as a Subject Matter Expert (SME) and
internal resource for the team and participates in process improvement projects.
Education and Experience High school diploma or equivalent required. Two to three years’ experience in patient access or related healthcare experience is required. Two years’ insurance verification experience is required. Intermediate knowledge of Windows computers and data entry is required. Experience with billing, insurance verification, coding, authorization guidelines, ICD 10 and CPT-4 coding, and/or medical terminology preferred. Degree and/or certificate or formal training in a related field preferred.
areas: employee relations, employment, labor relations, affirmative action and employment equity programs, employee recognition programs, benefits, compensation, talent acquisition, and training and development. Position has cross functional knowledge of all areas of Human Resources to support the organization needs within this role.
Assists with the day to day operations of the HR Help Desk. The Human Resources Generalist supports HR practices and objectives that will provide an employee-oriented, high-performance culture that emphasizes empowerment, quality, productivity and standards, goal attainment, recruitment and ongoing development of a superior workforce. Key functions include:
Act as a trusted advisor to management and employees, addressing HR-related inquiries and providing guidance on policies, procedures, and best practices. Advises leaders on disciplinary action of staff to include suspension and/or termination of employment related to breaches, license expiration, I-9 work eligibility, performance and absenteeism.
Report on key HR data metrics, monitoring trends, and working with managers to identify strategies for improvement. Mentors and coaches the HR Associates on processes, tasks, and problem solving. Lead/Participate in HR projects from inception to completion. Lead performance improvement activities, and solutions including succession planning and
play a key role in the implementation of HR initiatives, identifying opportunities for improvements.
Stay up to date with HR industry trends and best practices, providing insights and recommendations to enhance the organization's HR strategies. Ensure compliance with federal, state, and local employment laws and regulations. Analyze HR metrics and data to identify trends and areas for improvement. Performs other duties as assigned Education and Experience Bachelor's degree or equivalent experience Minimum 3 years’ experience in Human Resources Specialized knowledge in employment law, compensation, organizational planning, organization development, employee relations, preventive labor relations, benefits, and recruitment Strong background in Microsoft Office Suite Understanding of HR fundamentals, practices, and current regulations Knowledge of applicable state and federal employment and labor laws, specifically CA/US labor law Competent in HRIS systems
Property Id: 1242800
HOUSE IS FULLY FURNISHED.
BRING YOUR LUGGAGE AND CALL THIS YOUR HOME
A renovated spacious high-ceiling home is in a safe area. It sits among the neighborhoods grand houses near Mile Square Park. Minutes to Disneyland, Convention Center, Restaurants, Shopping, and Beaches.
House has 4 bedrooms & 3 baths
Room 1 - Master bedroom
Spectacular views of the Pacific Ocean and Catalina Island await you in the stunning Tuscan estate situated in the exclusive 24-hour guard gated community of Coastal Canyon.
Entering through a private courtyard, the open floor plan of this four-bedroom home with a separate casita is adorned with soaring ceiling, stunning staircase design, travertine
Welcome home to this brand-new modern masterpiece with a rare entertainers’ basement level.
This 3-bedroom front home boasts a fantastic floor plan with seamless indoor-outdoor space. All bedrooms offer ensuite baths with the bonus of 2 guest powder rooms. The gourmet open concept kitchen feature natural quartzite counters, Thermador appliances,
Lovely 2 story townhome, 3 bedrooms, 2 bathrooms, 2 car garage with direct access, washer and dryer hook-ups in the desirable Village Walk community.
Remodeled kitchen showcases modern cabinets, granite counter tops, stainless steel appliances and microwave. It's ready to make your favorite meals. Spacious master bedroom with walk-in closet
