Job Details

The role of Funding Specialist is responsible for securing funding for payers for all outpatient services including, ambulatory practices, day surgery, and imaging services. The position will receive patient referrals and authorizations from the payers and Primary Care Physicians including external /internal departments that need authorizations from the appropriate governmental agency or insurance company. This position is accountable for obtaining and processing of CCS, Government or Commercial insurance for the appropriate authorization of initial and/or follow up services. These referrals/authorizations must be processed as timely and accurately as possible with respect to the services that are to be rendered. This position will work closely with the Point of Care Departments and Patient Accounting in order to ensure timely communication and follow up regarding the authorization status of each patient(s).

With more than 670 physicians and 3,500 staff, Valley Children’s Healthcare delivers high-quality, comprehensive care to more than 1.3 million children across Central California. Our 358-bed stand-alone children’s hospital and network of specialty care centers and primary care practices offer advanced pediatric services - from cancer and blood disorders to heart care and neonatal intensive care, serving children with conditions ranging from routine to rare and complex. Beyond clinical care, Valley Children’s is also a catalyst for community health - partnering with schools, nonprofits and public agencies to expand access, promote wellness and support the long-term success of children and families throughout the region.

EXPERIENCE:

• Minimum one (1) year related experience in obtaining medical insurance, government authorizations or medical insurance/government billing
• Medical terminology, previous registration and/or billing experience in physician practice, clinic/hospital care setting
• Working knowledge of Excel software
• Skills critical for success
  • Strong communication
  • Problem solving
  • Analytical skills
  • Interpersonal skills
  • Time Management
  • Critical thinking

EDUCATION/LICENSES/CERTIFICATIONS:

• High School diploma as accredited by the US Department of Education or GED required

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Disclaimer:  Final compensation will be dependent upon skills and experience.