Job Description
We are seeking a detail-oriented and customer-focused Healthcare professional to support both clinical resource intake and/or premium billing functions for a wonderful client in Natomas. This role is ideal for professionals with experience in healthcare administration, billing, and member services, particularly within HMO environments.
Key Responsibilities:
- Coordinate and process medical service authorization requests from providers, including out-of-area ER visits, inpatient admissions, and specialized procedures.
- Maintain accurate accounts receivable records, including payment processing, reconciliation, and reporting.
- Serve as a primary contact for member and provider inquiries related to billing, authorizations, and case management referrals.
- Log and track authorization cases, ensuring timely notifications and documentation.
- Support cross-functional teams including Member Services, Claims, and Utilization Management.
- Educate members, providers, and internal staff on billing tools, authorization procedures, and plan updates.
- Perform administrative tasks such as data entry, report generation, and record retention.
Qualifications:
- Minimum 1 year of experience in healthcare administration, billing, or customer service-preferably within an HMO setting.
- Proficiency in Microsoft Office Suite, especially Excel (formulas, graphs).
- Familiarity with healthcare software systems (e.g., Facets) is a plus.
- Strong communication, attention to detail, and time management skills.
- Ability to handle sensitive information with integrity and professionalism.
All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. For unincorporated Los Angeles county, to the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.