About Us
All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients. ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. We offer a flexible work environment and schedules with work from home options. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees. We also offer paid holiday, sick time, and vacation time as well as a 401k plan. Additional employee paid coverage options available.
Job purpose
The California Children Services (CCS) Coordinator is responsible for managing and coordinating services for children with eligible medical conditions under the California Children Services (CCS) program. This position involves working closely with families, healthcare providers, and community resources to ensure that children receive comprehensive and effective care. The Coordinator will also handle case management, ensure compliance with CCS regulations, and provide support to families throughout the process.
Duties and responsibilities
· Applies California Children Services policy and follows State guidelines in the issuance of CCS services.
· Receive, review, and disposition Service Authorization Requests (SAR’s).
· Review electronic medical reports, perform data entry into the State CMSNET database.
· Reviews medical reports and correspondence on assigned cases and coordinates the arrangements for approved medical services
· Provides consultation to families, providers, and other community agencies in an effort to improve health at the individual/family, community and systems levels of practice related to the CCS population.
· Assist the CCS Case Manager in reviewing discharge summary/instructions
· Arrange member’s post-discharge follow-up visits with PCP and/or Specialists.
· Reviews medical records and contacts the member or member’s parent/guardian to assess member’s social and health related needs/concerns.
· Assist CCS Case Manager with care plan goals to be discussed with member or member’s parent/guardian
· Makes sure that member or member’s parent/guardian is aware that member has an active CCS case and the benefits of CCS program
· Assist the patients by arranging appointments with the specialist & PCP office, and to check status of ancillary services like DME, therapy, Home Health if already provided to the member.
· Assist the CCS Case Manager with claims review on all CCS diagnoses.
· Respects the dignity, confidentiality and privacy of each patient and adheres to HIPAA regulations and policies.
· Assists the CCS Case Manager with monthly, quarterly and annual CCS reporting logs within established timeframe
· Assist in all Health Plan and DHCS audits
· Coordinates and completes special projects as delegated by the CCS Case Manager
Qualifications
· High School Graduate or equivalent
· A minimum of 2 year experienced in managed care environment to include but not limited to an IPA or MSO preferred.
· Knowledge of medical terminology, RVS, CPT, HPCS, ICD-9/10 codes
· Spanish/English bilingual preferred
· Proficiency using Outlook, Microsoft Teams, Zoom, Microsoft Office (including Word and Excel) and Adobe
· Strong ability to multi-task and work in a fast-paced environment
· Strong ability in problem-solving
· Ability to work in an extremely confidential environment
· Strong written and verbal communication skills
· Technology savvy and highly organized
Education and Additional Requirements
· Highschool Degree or GE Certificate required
Working conditions
· This job may require flexible work hours due to the nature of the responsibilities
· Candidate must be comfortable with ambiguity and open to working in a collaborate environment
Job Type: Full-time
Pay: $22.00 - $30.00 per hour
Experience:
- California Children Services (CCS): 1 year (Preferred)
- Managed care: 1 year (Preferred)
Location:
Work Location: Remote