The County of Riverside - Riverside University Health System (RUHS) - Medical Centeris seeking an Admissions & Collections Clerk to join their Insurance Verification/Qa team in Moreno Valley.
Under general supervision, incumbents will be responsible for working off WQ's for verifying eligibility for insurances, and verifying authorizations and referrals for accuracy, communicating with admitting and registration, clinics, ER, MISP, operating room, PSC staff as needed; specializing clerical work in checking-in, admitting, pre-registering, or scheduling patients for hospitalization or clinic visits, evaluating and determining financial liability for services and establishes payment sources, arranging payment plans consistent with patient ability to pay, and performing other related duties as required.
This is a high-paced and high volume position. The department works closely with admitting/registration, clinics, ER, MISP, operation room, and PSC's to obtain insurance coverage and verify authorizations/referrals for high dollar procedures such as surgeries, infusions, and GI's. The department is split up into several micro departments as they work inpatient admissions, elective high dollar procedures, ER review, billing edits, and returned mail.
This position telecommutes; the only time the incumbent would be expected to drive is for meetings, special events, and/or trainings.
Professional experience with the following is preferred:- Bilingual- Authorizations and referrals- EPIC- IEHP, Medi-Cal, managed Medi-Cals, and Medicare- GI's- Infusions- Inpatient admissions and surgeriesWork Schedule: 5/40 - Monday through Friday, 8:00am - 4:30pm
Meet the Team!
Founded in 1893, Riverside University Health System Medical Center has grown into a cornerstone of healthcare excellence and medical education in the region. Our highly skilled healthcare professionals and dedicated support staff are committed to delivering exceptional, state-of-the-art care to the diverse populations of Riverside County.
Located in Moreno Valley, our 439-bed Medical Center is home to a Level I Trauma Center, a Level II Pediatric Trauma Center, and the county’s only Pediatric Intensive Care Unit (PICU). If you’re passionate about making a meaningful difference and helping others, RUHS Medical Center is the place for you!
For more information about RUHS Medical Center, please visit www.ruhealth.org
•Review patient personal data to evaluate the patient's eligibility for medical assistance programs using formal medical program guidelines.
•Review patient insurance forms and cards to ensure completeness and accuracy as required by assistance programs and private insurance carriers for billing and payment.
•Evaluate possible assistance eligibility and refer patients to Medi-Cal and MISP as appropriate.
•Contact patient's medical insurance carrier to obtain authorization for treatment and verify eligibility and coverage.
•Assist patients with scheduling hospital or clinic appointments in person or over the phone.
•Pre-register scheduled services during scheduling process or any time prior to receiving services as directed by supervisor or manager.
•Receive and record payments for medical treatment from patients.
•Record payment information on patient payment receipt and log this information on the appropriate forms.
•Complete patient medical information or MISP Share of Cost Forms; attach cash payment receipt to ensure reimbursement from medical assistance program.
•Refer patients with problem accounts to Patient Accounts for review of account status.
•Receive required information from patients and complete medical forms to ensure accuracy of patient data.
•Collect and prepare receipt for monies.
•Register patients for medical services such as emergency treatment and non-emergency walk-in treatment.
•Serve as a resource person for patient registration in the Riverside University Health System (RUHS) clinics.
•Assist in conducting outpatient registration audits and participate in RUHS quality assurance initiatives.
•Reconcile daily charge sheets of patient visits to ensure that charges for healthcare services rendered are captured in a timely manner.
OPTION I
Experience: Two years of clerical experience, including three months performing admissions, collections or billing functions in a hospital, mental health or other healthcare setting. (Completion of 18 semester or 27 quarter units from an accredited college or university in secretarial sciences, office practices, business education, or a closely related field to the assignment may substitute for one year of the non-specialized experience.)
OPTION II
Experience: Two years of clerical experience, including three months performing admissions, collections or billing functions in a hospital, mental health or other healthcare setting. (Completion of 360 hours of training from a recognized occupational training program in secretarial sciences, business education or a closely related field to the assignment may substitute for one year of the non-specialized experience.)
OPTION III
Experience: Two years of clerical experience, including three months performing admissions, collections or billing functions in a hospital, mental health or other healthcare setting. (Six months of clerical experience in a medical setting may substitute for one year of the non-specialized experience.)
ALL OPTIONS
Knowledge of: Modern office procedures, including the preparation of reports and correspondence and filing; the operation of standard office equipment and medical terminology.
Ability to: Perform complete registration cycle, including collection of monies; effectively interview to obtain personal, family and financial information; gather, record and evaluate data in the admission of hospital patients and the handling of patient accounts; maintain accurate records; apply the rules and regulations pertaining to the admission of patients, private and public medical insurance, billing procedures, credit authorizations, and payment agreements; work with very ill, injured and emotionally distressed people.
Physical Requirements:This position will require repetitive motion due to data entry in EPIC.Application Status
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Go to www.RC-HR.com, click on "Careers", click on "County Job Openings", and click on "Subscribe to Job Alerts" icon.
For questions regarding this recruitment:
Contact Raven Padilla at rpadilla@rivco.org or 951/955-0780. Please allow 1-2 business days for response to general inquires. 
