Job Details Level : Experienced Job Location : Gardena, CA Position Type : Full Time Salary Range : $21.00 - $23.00 Hourly Job Shift : Day Description Statement of Purpose
Under the direction of the Licensed Clinical Care Coordinator, the Care Coordinator initiates calls with potential patients and insurance companies, verifies insurance benefits for patients, performs utilization review, and outreach to insurance companies to update and obtain private insurance contracts. The CC is a member of a multidisciplinary team; essential duties include but are not limited to: verification of benefits, insurance navigation, and client advocacy with providers. Communicates professionally, obtains accurate information, and advises the team and patient.
Major Tasks, Duties, and Responsibilities Verifies and confirms insurance coverage with insurance companies by diagnostic and procedural codes.
Provides a centralized contact point between BHS service providers, insurance companies, and patients.
Must have excellent written and verbal communication skills. Be familiar with insurance terminology, policies, and industry rules.
Other duties include reviewing patient cases, ensuring timely processing of benefit information, participating in utilization review, supporting billing reconciliation, advocating for patients, responding to inquiries, maintaining confidentiality per HIPAA, and demonstrating professional and ethical behavior. Knowledge of drug and alcohol dependency, mental health, and family systems is preferred. Basic understanding of referrals and computer operations is required.
Care Coordinator Competencies and Performance Expectations Verify insurance benefits
Communicate with insurance companies for preauthorization and benefits coordination
Advocate for patient care needs with insurance companies and staff
Maintain records of private insurance patients
Adhere to professional standards
Qualifications Prerequisite Qualifications
Must have a bachelor’s degree in health or human/social services or a related field, certification as a chemical dependency counselor, and a minimum of five years experience in substance abuse. Knowledge of insurance benefits and medical terminology is required. Bilingual abilities may be required in some programs. Valid California driver’s license and liability insurance are necessary if driving a personal vehicle for BHS business. Must meet health and physical requirements, including vision, hearing, and manual dexterity. Specific qualifications may vary; the supervisor will specify applicable items, e.g., class “C” driver’s license, first aid, CPR, bilingual skills, etc.