Intake Processor (Part Time)
Are you looking for a part time role that offers fantastic benefits? Our expanding Care Management department is looking for a passionate part time Intake Processor to join their team to help Health Plan of San Joaquin continue to serve our community and provide access to high quality care to our members.
What You Will Be Doing:
In this role you will support our Inpatient division of our Care Management department, where you will be responsible for initial processing of provider requests for authorization. In supporting our Care Management team, our part time role is scheduled for regular shifts on Mondays, Fridays and Saturdays.
- Reviews and verifies authorizations received from provider portal, fax or other sources for accuracy and completeness, including but not limited to eligibility, clinical information and other supporting documentation.
- Processed auto-approve items as directed and per guidelines.
- Obtains required documentation and information from a variety of internal and external resources, including but not limited to providers; routes to clinical staff for review.
- Monitors deferrals; contacts providers and generates required letters for approval; distributes as required.
- Builds cases by entering data into appropriate systems.
What You Bring:
- Produces work that is accurate and complete.
- Produces the appropriate amount of work.
- Actively learns through experimentation when tackling new problems, using both successes and failures to learn.
- Rebounds from setbacks and adversity when facing difficult situations.
- Knows the most effective and efficient process to get things done, with a focus on continuous improvement.
- Interpersonal skills - interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.
- Strong oral and written communication skills, with ability to express self clearly and professionally, with appropriate grammar and spelling, and document according to standards.
- Strong listening skills, with the ability to accurately receive and understand messages.
- Basic conflict resolution skills, with the ability to use tact and diplomacy to diffuse emotional situations.
- Ability to work independently and as part of a team.
- Demonstrates commitment to HPSJ’s strategy, vision, mission and values.
- Ability to read, understand and apply complex written guidelines, instructions and other materials.
- Ability to compare and discern the difference between multiple sets of data or information.
- Strong organizational skills, with the ability to effectively prioritize and complete multiple tasks.
- Basic problem solving and analytical skills, including the ability to perform routine analysis and solve problems using identified data and information.
- Basic arithmetic skills.
- Basic skills in Windows, Excel, Word and Outlook.
- Ability to navigate multiple systems and resources simultaneously.
- Ability to treat confidential information with appropriate discretion.
- Ability to speak and be understood in English.
- Knowledge of Medi-Cal programs and benefits
- Knowledge of managed care
- Knowledge of medical benefits and exclusions
- Knowledge of medical terminology
- Knowledge of ICD and CPT coding
- May require proficiency in one of HPSJ’s threshold languages (as defined by HPSJ’s Cultural and Linguistic Program).
What you Have:
- High school diploma or general education degree; and
- At least two years of general clerical or data entry experience; or
- Equivalent combination of education and experience.
- Associate’s Degree
- Experience in a similar position
- Experience working with Medi-Cal beneficiaries and providers.
What You Will Get:
- HPSJ Perks:
- Competitive salary
- Robust and affordable health/dental/vision (90% paid medical for employees and 100% paid dental/vision for employees) with choices in providers
- Generous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)
- CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution plan
- Two flexible spending accounts (FSAs)
- Employer-Paid Term Life and AD&D Insurance
- Employer-Paid Disability Insurance
- Employer-Paid Life Assistance Program
- Health Advocacy
- Supplemental medical, legal, identity theft protection
- Access to exclusive discount mall
- Education and training reimbursement in addition to employer-paid elective learning courses.
- A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.
- A shorter commute – if you’re commuting from the Central Valley to the Bay Area.
- Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.
- Continuously improve the health of our community.
- We provide healthcare value and advance wellness through community partnerships.