Patient Services Coordinator-Provider Relations (Riverside)

The County of Riverside - Riverside University Health System (RUHS)- Provider Relations Department is seeking to fill two Patient Services Coordinator positions located in Riverside.
Under minimal supervision, performs a variety of administrative and clerical duties in support of the Riverside University Health System (RUHS) Managed Care or Care Management program, secures authorization for services, completes patient assessments for eligibility criteria; and performs other related duties as required.

Depending on area of assignment, the Patient Services Coordinator reports to either the Nurse Coordinator, Director of Nursing Services, or an appropriate Revenue Cycle Manager.

The Patient Services Coordinator class is primarily responsible for coordinating patient care at the RUHS ambulatory clinics or for coordinating referrals generated with contracted Managed Care Plans, both public and private.

In addition, this class coordinates with physicians and mid-level providers regarding patient care or IPA's for all patients scheduled for appointments at RUHS, and obtains all authorizations necessary for patient care.

Other duties include but are not limited to the following:


* Submitting and obtaining authorization services which includes clinic visits, specialty visits, outpatient surgeries and eConsults.


* Liaison between healthcare staff and patients regarding maintenance of care and treatment.


* Daily intake and outbound calls to input data into EMR and verify member eligibility.


* Customer service and tracking of pending referrals.


* Ensuring correct CPT and ICD-10 codes are valid.


* Submits/Obtains authorization from the payer.


* Running eligibility.


* Manages ED and Inpatient discharges.


* Procures authorization.


* Incoming/Outbounds calls.

The most competitive candidates will have the following experience:


* Authorization, insurance and eligibility experience.


* Strong customer service skills.


* Clinical background.

Work Schedule: Will be discussed during the interview.

(Tentative: 5/40, Mon.-Fri, 8am-4:30pm)
Work Location: Mission Grove (7888 Mission Grove Pkwy, Riverside Ca 92508), Telecommuting position

Meet the Team!

Riverside University Health System• Assist physicians and other healthcare providers by providing care coordination to ensure patients receive optimal care; interact with Primary Care Providers, Specialty Providers, and other healthcare staff to coordinate care for patients.

• Liaison between healthcare staff and patients regarding maintenance of care and treatment; work closely with Providers to ensure continuity of care and treatment; facilitate communication among patients, physicians, nurses, and other healthcare staff regarding their care, including making appointments, treatment authorizations and resource needs.

• May assist with patient referrals to appropriate community resources; may provide patient education.

• Daily management of ...