Career Center

Required:

• Working knowledge of third party payer verification terminology
  
• Working knowledge in the functional operations of third party payors and utilization review agencies to expeditiously coordinate follow-up
• Working knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid, or other sponsoring agencies
• Working knowledge of health plans with special processing requirements for emergency patients and ability to effectively communicate these requirements to physicians and administrative personnel under time urgent conditions. 
• Ability to scrutinize credit reports and evaluate personal financial information to detect any problems, discrepancies or questionable areas and set up an appropriate financial arrangement when necessary (May be trained)
  
• Ability to attend to many details within a short span of time
• Knowledge of the availability of specific accommodations for patients on various nursing units to initiate proper room and care charges (May be trained)
• Skill in detecting erroneous data input that would otherwise disable census system output mechanism
  
• Working knowledge of HMO’s and PPO’s, in order to understand, explain and calculate Per Diem rates, contractual allowances and percentage discounts.
• Skill in computing rations, rates and percentages in order to calculate estimated pro-rated balances and patient liability.
• Skill in analyzing information, problems, situations, practices or procedures in order to define the problem/objective; identify relevant concerns/factors; identify patterns, tendencies or relationships,; formulate logical and objective conclusions; recognize alternatives and their implications

Preferred:

• Working knowledge of the department functions of an acute care hospital and their organizational interrelationships
• Knowledge of physician team and specialty to accurately validate medical services rendered to patients
• Ability to monitor bed availability, predict, and communicate possible problems to appropriate departments