Admissions & Collections Clerk - Insurance Verification/QA

The County of Riverside - Riverside University Health System (RUHS) - Medical Center is 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 surgeries
Work 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 hosp...