Health care jobs in West Covina, California - Page 14Create job alerts

Job DescriptionDescriptionJob Title: Customer Services Representative Department: Operations - Member Services About the Role: Astrana is looking for a Customer Service Representative to join our fast and growing Dynamic team. What You'll Do • Answer all daily telephone calls from members, providers, health plans, insurance brokers, collection agents and hospitals, • Collect Elicit information from members/providers including the problem or concerns and provide general status information, • Verify authorization, claims, eligibility, and status only, • All calls carefully documented into Company’s customer service module & NMM Queue system, • Member/Provider Service/Representative assists Supervisor and Manager with other duties as assigned, • Member outreach communications via mail or telephone, • Assist Member appointment with providers, • Resolve walk-in member concerns, • Able to provide quality service to the customers, • Able to communicate effectively with customers in a professional and respectful manner, • Maintain strictest confidentiality at all times, • Specialist termination notifications sent to members, • Urgent Medicare Authorization Approval – Notification to Medicare members, • Transportation arrangement for Medicare & Medi-Cal members, • Outreach Project Assignments INBOUND CALLS:, • Member/Provider/Health Plan/Vendor/Hospital/Broker:, • All calls carefully documented into Company’s customer service module, • Annual Wellness Visit (AWV) – Gift card pick up and schedules, • Appointment of Representative (AOR) for Medicare Members, • Attorney / Third Party Vendor calls, • Authorization status/Modification/Redirection/CPT Code changes/Quantity adds/Explain Denied Auth/Peer to Peer calls/Extend expired auth/Pre-certified auth status/Retro/2ndor 3rd opinion/, • Conduct 3 way conference call to Health Plan with member, • Conference call with Providers – Appointments, DME,, • COVID – 19 related questions (Tests & Vaccines), • Direct Member Reimbursement (DMR), • Eligibility – Demographic changes: Address/Phone/Fax Changes/Name change, • Escalated calls from providers/members, • Health Diary Passport, • Health Source MSO – Assist & arrange inquiries on Eligibility/Change PCP/Benefit with AHMC, • HIPPA Consent – Obtain Member Consent verification, • Inquiries on provider network/provider rosters, • Lab locations, • Member & Provider Complaints/Grievances, • Member bills, • Miscellaneous calls, • Pharmacy – Drug/medication pick up and coverage, • Provide authorization status for Hospital /CM Dept, • Self-Referral Request for Medicare, • Return Mail, • Track Mail Packages/ Certified mail status, • Translations – Spanish / Chinese, • Urgent Care / locations/ operations hours OUTBOUND CALLS: Member/Provider/Health Plan/Vendor/Hospital/Broker:, • Assist Case Management on CCS – age in 21 years for change of PCP from Pediatrics to FP/IM, • Assist Marketing on email inquiries, • Assist PR/ Elig – Members assigned to wrong PCP/with no PCP status, • Assisted UM / Medical Directors on urgent member appointment from escalated cases, • Authorization status response call back, • Benefits – return call once information is obtained / verified, • Complaints/Grievances – return calls once resolution is obtained, • DME – Translation support in Spanish and Chinese to confirm item / appointment set up for DME department, • Eligibility – return call to providers/labs when member is added to system while waiting at the office., • Member bills – return calls once resolution is obtained, • Member Survey – Annually: every 4thquarter, • Outreach project from internals – QCIT, • Resolve walk in members concerns, • Specialist Termination notification sent to members, • Transportation arrangement for Medicare / Medi-Cal members, • Voice mail – return calls back to callers CONCIERGE SERVICES – ESSENTIALS DUTIES AND REQUIREMENTS:, • Assist to contact new members/IPA member transfer on new PCP assignment as needed, • Work group discussions on work status/progress on new member/IPA transfer, • Update call log and provide daily/weekly status as needed, • Facilitate members with complex pre-existing conditions, medications, PCP/SPC network reviews, • Conference call with PCP selection / change, • Help member to identify member bill status, connect provider with on billing and claim submission, • Responsible for experience of the membership associated with new member/IPA transfer, • Responsible for to interact with Health Plan’s Customer Service Team to serve new member/IPA transfer, • High School Diploma or GED, • Experience using Microsoft applications such as Word, Excel and Outlook, • Experience working in customer service, • One year related experience and/or training; or equivalent combination of education and experience, • You are fluent in Mandarin or CantoneseYou're a great for this role if:, • This is a remote role. The home office is aligned with your department at 9700 Flair Drive, El Monte, CA 91731, • This position will typically work Monday - Friday from 8:30am to 5:00pm PST., • The target pay range for this role is $20.00. This salary range represents national target range for this role.

Job Description Who are we? 360 Behavioral Health provides exceptional care for individuals with autism and developmental delays. With over 30 years of expertise, we are a leading authority in ABA-based behavioral health services. Founded by a husband-and-wife team, our mission is to transform lives through a comprehensive range of services, including Applied Behavior Analysis, personal assistance, and respite. Our qualified clinicians use evidence-based practices and personalized treatment plans to improve outcomes for individuals with autism and their families. As one of the top ABA services providers in the United States and a certified Great Place to Work, our commitment and dedication continue to drive our exceptional care. What would this role do? The Administrative Assistant plays a critical role in guiding the professional growth of our team, from clinician skill development to leadership enrichment. This position will support the efforts of the entire local office staff and will work as a team to provide exceptional care to everyone that is served. What we offer (We like to get right to it!) • Competitive compensation (we value transparency) $17.00-$19.00/hourly, • Monday-Friday 8:00am – 5:00pm on site, • Student loan repayment assistance for eligible roles, • Bonus program(s) for eligible roles, • Career development and advancement opportunities, • Flexible scheduling, • Great and fun company culture, • Expansive Health, Vision, and Dental plans for our full-time partners, • 401(K) retirement savings program, • Mileage and phone reimbursement, • Reception Duties include but not limited to taking incoming calls, taking/delivering messages, voicemails, mail, copies, templates, and ensure the front area is always clean, organized, and presentable to uphold the image of the clinic., • Manage the Client electronic records system. (e.g. Assigning Providers, updating client information, uploading documents, adding notes), • Support all Administrative and Clinical Teams., • Ensure understanding, implementation, and reinforcement of all company policies and procedures., • Support the training team assigning training, scheduling, and set up. (e.g. CPI), • Track and maintain office supply orders., • Attend and/or run recurring or scheduled meetings (i.e. staff meetings, administrative meetings), • Manage the Client documents including but not limited to client service agreements, and special incident reports., • Support for internal and external audits., • Ensuring that the company’s “zero tolerance policy” is understood, implemented, and reinforced in the region., • Ensuring that Health Insurance Portability and Accountability Act (HIPPA) compliance is understood and reinforced in the region., • Provide comprehensive support to all company staff, addressing their various needs promptly and effectively., • Collect staff documentation and provide it to the People Operations department for internal filing., • Email communications to all clinical and administrative partners., • Ensure all staff are in compliance with Company requirements (Credentialing, certifications, etc.)., • Track and maintain data sets within spreadsheets, ensuring accuracy and organization. This includes but is not limited: incomplete sessions, schedule changes, and billable hours., • Complete all duties and/or special projects assigned by leaders and/or the business., • Assist with People Operations initiatives as assigned., • Assist with administrative team duties as assigned., • Ensure regulatory compliance with insurance protocols, HIPPA, and other federal, state, and local regulations., • Participating in team meetings, trainings, and professional development opportunities., • Minimum high school diploma or GED, • 6 months of Office experience preferred., • Self-motivated, responsible, honest, and articulate., • Excellent organizational, communications, and time management skills., • Customer service focus-with a professional demeanor, boundaries, and composure. EEO/Minorities/Females/Disabled/Veterans Our organization is an equal employment/affirmative action employer. If you need accommodation for any part of the employment process because of a medical condition or disability, please send an e-mail to to let us know the nature of your request. For more EEO information about applicant rights click here. Americans With Disabilities Act 360 Behavioral Health, does not discriminate on the basis of disability in its services, programs, or activities. Employment: 360 Behavioral Health does not discriminate based on disability in its hiring or employment practices and complies with the ADA title I employment regulations. Effective Communication: 360 Behavioral Health will, upon request, provide auxiliary aids and services leading to effective communication for people with disabilities, including qualified sign language interpreters, assistive listening devices, documents in Braille, and other ways of making communications accessible to people who have speech, hearing, or vision impairments. Modifications to Policies and Procedures: 360 Behavioral Health, will make reasonable modifications to policies and procedures to ensure that people with disabilities have an equal opportunity to enjoy programs, services, and activities. For example, people with service animals are welcomed in 360 Behavioral Health offices, even where pets and other animals are prohibited. Requests: To request an auxiliary aid or service for effective communication, or a modification of policies or procedures contact [ADA Coordinator name and contact information] as soon as possible, preferably 30 days after the activity or event. For inquiries, please contact us at Keywords: ABA, Applied Behavioral Analysis, CNA, Certified nurse assistant, behavioral health, RBT, Registered Behavioral Tech, Mental Health, Entry Level, Aid, Respite Care, Caregiver, Paraprofessional, Assistant, Home Health, DSP, Direct Support Professional, Patient care technician, Care Tech, LPN, Psychology