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Credentialing specialist Jobs in Santa Rosa, CA

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Credentialing specialist • santa rosa ca

Last updated: 1 day ago
Referrals Specialist

Referrals Specialist

Petaluma Health CenterRohnert Park, CA, US
Full-time
The Petaluma Health Center's mission is to provide high quality health care with access for all in Southern Sonoma County & West Marin. We pride ourselves on our Patient-Centered care while maintain...Show moreLast updated: 16 days ago
Delivery Specialist

Delivery Specialist

O'Reilly Auto PartsSanta Rosa, CA, US
Full-time
The actual hourly rate will equal or exceed the required minimum wage applicable to the job location.Additional compensation includes annual, quarterly performance, or premiums may be paid in amoun...Show moreLast updated: 30+ days ago
Credentialing Specialist

Credentialing Specialist

VirtualVocationsSanta Rosa, California, United States
Full-time
A company is looking for a Credentialing Specialist responsible for managing the credentialing processes for healthcare providers. Key Responsibilities Ensure timely processing of Primary Source V...Show moreLast updated: 30+ days ago
Merchandiser Specialist

Merchandiser Specialist

Premium Retail Services IncRohnert Park, CA, US
Full-time
Bring Brands to Life and Build Your Career.Join Premium Retail Services as a Merchandising Specialist, where you'll bring top brands to life in stores across your community.You'll represent hundred...Show moreLast updated: 15 days ago
Litigation Support Specialist

Litigation Support Specialist

Considine SearchSanta Rosa, CA, US
Full-time
Docketing & Court Services Clerk.Remote (Pacific Standard Time).The Docketing & Court Services Clerk will be responsible for providing first-level support for the Firm's automated docket an...Show moreLast updated: 12 days ago
Field Operations Specialist

Field Operations Specialist

AgtonomySanta Rosa, CA, US
Full-time
Agtonomy is pioneering advanced automation and AI solutions to transform agriculture and beyond.Initially focused on specialty crops, our TeleFarmer™ platform addresses labor-intensive needs ...Show moreLast updated: 1 day ago
  • Promoted
Gardening Specialist

Gardening Specialist

Sonoma State UniversityRohnert Park, CA, United States
Full-time +1
Unit 5 - CSUEU - Operations and Support Services, Custodial / Facilities, Probationary, Full Time.This position is open until filled. For full consideration, please submit application, along with cove...Show moreLast updated: 30+ days ago
Cardiology Specialist Opportunities

Cardiology Specialist Opportunities

beBeeCareerSanta Rosa, US
Full-time
Seeking Cardiology Professionals.Immediate openings exist for skilled physicians in the field of cardiology.This opportunity is ideal for those seeking a challenging role within the medical sector....Show moreLast updated: 4 days ago
RN Care Specialist

RN Care Specialist

Bethesda HealthSanta Rosa, CA, United States
Part-time
Bethesda Brings out the Best in Talented, Caring People! At Bethesda, more than 1,200 employees dedicate their careers to improving the lives of others. As a team member at Bethesda, you'll enjoy gr...Show moreLast updated: 11 days ago
  • Promoted
Functional Support Specialist

Functional Support Specialist

OdooSanta Rosa, CA, US
Full-time
Functional Support Specialist / Technical Support Specialist.This is a hybrid (40% remote and 60% onsite) role in San Francisco, CA. To get the best candidate experience, please consider applying fo...Show moreLast updated: 17 days ago
Payroll Specialist

Payroll Specialist

Northbay RecruiterSanta Rosa, CA, US
Full-time
We are seeking a skilled payroll specialist with experience in the construction industry.The ideal candidate will have experience in payroll processing, prevailing wage calculations, and certified ...Show moreLast updated: 2 days ago
Residential Sales Specialist

Residential Sales Specialist

Western ExterminatorSanta Rosa, CA, US
Full-time +1
Benefits Start Day 1 for Full-Time Colleagues - No Waiting Period!.For more information about our benefits, see below!.We are proud to be a member of the Rentokil family of companies, the global le...Show moreLast updated: 30+ days ago
Store Protection Specialist

Store Protection Specialist

Ross StoresSanta Rosa, CA, US
Full-time
This position provides a visible presence at the Store entrances / exits, mitigating theft and fraud and maintaining a safe and secure environment for Associates and Customers.The Specialist makes ey...Show moreLast updated: 2 days ago
Collections Specialist

Collections Specialist

Exchange BankSanta Rosa, CA, US
Full-time
Produce and maintain department reports, including past due, work in progress, Notice of Default, REO and other various weekly and monthly accountings. Update, maintain and track various spreadsheet...Show moreLast updated: 16 days ago
Mail Processing Specialist

Mail Processing Specialist

Postal SourceSanta Rosa, CA, United States
Full-time
NO EXPERIENCE REQUIRED – PAID TRAINING PROVIDED – JOB SECURITY.The Postal Service is the largest government related agency in terms of employees. The Postal Service currently employs nearly 1 millio...Show moreLast updated: 12 days ago
Project Support Specialist

Project Support Specialist

Morris Group, Inc.Windsor, CA, United States
Full-time
Join a USA Today Top Workplace! Morris Group, Inc.North America, is a third generation, family owned and operated business that serves manufactures of precision machined parts in the United States...Show moreLast updated: 30+ days ago
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Referrals Specialist

Referrals Specialist

Petaluma Health CenterRohnert Park, CA, US
16 days ago
Job type
  • Full-time
Job description

Description

The Petaluma Health Center's mission is to provide high quality health care with access for all in Southern Sonoma County & West Marin. We pride ourselves on our Patient-Centered care while maintaining an engaging environment for our staff. The Center accomplishes this mission through collaborative, innovative programs, services and referral resources that meet the economic needs of the entire community.

FULL TIME EMPLOYEE BENEFITS :

  • 21 Days of Paid Time Off
  • 10 Observed Holidays
  • Medical Insurance (Entire deductible paid by us!)
  • 30 Chiropractor and Acupuncture visits per year included with enrollment in our health insurance plans (Kaiser and WHA)
  • Dental Insurance
  • Vision Insurance
  • Gym Membership Discounts at Synergy Health Club and 24-Hour Fitness!
  • 401K Matching after 1 year of employment
  • Flexible Spending Account, Dependent Care FSA
  • Life Insurance (included at no cost to the employee)
  • Long Term Disability (included at no cost to the employee)
  • Employee Assistance Program (included at no cost to the employee)

Summary : Entry level position responsible for providing excellent patient care and customer service by ensuring that a patient's insurance allows them to access specialty services via coordination, processing, and completing of all internal and external specialty clinic referrals authorizations within expected timeframe.

Areas of Responsibility :

Patient Care

  • Verification of patient insurance eligibility.
  • Maintains updated authorizations / referrals information in patient chart through a tracking mechanism.
  • Provides assistance to uninsured patients to be enrolled in PAP program.
  • Provides information to patient through warm hand offs as needed.
  • Customer Service

  • Makes and / or answers phone calls regarding any referral questions.
  • Assist patients in the appeals process for denial of services through the proper appeals process with their insurance companies.
  • Maintain extensive resource directory for PHC staff and patients for access of community resources.
  • Referral Tracking

  • Process all outside referrals from other PCP / specialist within expected timeframe.
  • Closes 20 referrals daily.
  • Tracks the completion of the referral process within expected timeframe.
  • Track referrals by using structured data to maintain up to date accurate information.
  • Ensures follow up with Public Health Nurse for CHDP Referrals made.
  • Knowledge of managed care requirements for referrals.
  • Participates in MAA Coordination and Claims Administration, including but not limited to completion of the annual time survey.
  • Perform other duties as assigned by Referrals and Specialty Clinics Operations Manager or Director of Clinical Operations
  • Education / Experience

  • High school graduate with medical office training.
  • Two years experience with insurance, referrals, authorizations, and community contacts.
  • Desired Skills :

  • An energetic and creative individual with high standards and an appropriate professional image.
  • Proven ability to handle multiple projects and meet deadlines.
  • Versatility, flexibility and willingness to work within an ambiguous, fast-paced environment.
  • Demonstrated resourcefulness in providing solutions and setting priorities.
  • Effective interpersonal skills to work effectively with all levels within the health center.
  • Language Skills : Ability to communicate effectively in English and Spanish with children and adults in person, on the telephone, and in writing. Ability to effectively present information and respond to questions and requests from patients, co-workers and others as necessary.

    Petaluma health Center is an Equal Opportunity Employer. Petaluma health Center does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.