SUMMARY: 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).
JOB REQUIREMENTS: This position requires: A) High School Grad/GED; and B) minimum of one (1) year related experience in obtaining medical insurance, government authorization or medical insurance/government billing; and C) Strong communication skills, problem solving skills, analytical skills, interpersonal skills as well as time management and critical thinking skills; Preferred medical terminology, previous registration and/or billing experience in physician practice, clinic/hospital care setting and working knowledge of Excel software.
POSITION DETAILS: Per diem, 1.5 shifts per pay period, 7:30 AM - 4:30 PM
Valley Children’s Healthcare – one of the largest pediatric healthcare networks in the nation – provides Central California’s only high-quality, comprehensive care exclusively for children, from before birth to young adulthood. Our independent, nonprofit network offers highly specialized medical and surgical services to treat conditions ranging from common to the most unusual and complex at our 356-bed children’s hospital as well as through partner hospitals, specialty care centers, satellite practices and primary care services. Our family-centered, pediatric services extend from a leading pediatric cancer and blood diseases center on the West Coast, and our pediatric heart center known for its expertise and pioneering treatments, to our Level IV neonatal intensive care unit (NICU), the highest level referral center between Los Angeles and the Bay Area. Valley Children’s consistently ranks at the top of our peer group for quality patient outcomes, patient satisfaction and nursing excellence. Recognized as a Magnet® designated facility since 2004 and granted the gold-level Beacon Award for Excellence™ in critical care, Valley Children’s neonatal and pediatric intensive care units ac...hieve some of the lowest mortality rates in the country while treating some of the sickest kids. In affiliation with Stanford University School of Medicine, Valley Children’s Pediatric Residency and fellowship programs provide first-class training for the next generation of pediatricians and pediatric surgical and medical specialists. With more than 550 physicians and 3,400 staff, Valley Children’s partners with other providers and organizations throughout our 12-county service area to support delivering the best care to kids closer to home.