Top 18 Eligibility specialist Jobs in Redding, Ca

Transportation Specialist I - Sunday - Thursday 11:00am - 7:30pm
Partnership HealthPlan of California —Redding, CA
- $27.56 - $32.38 an hour
- Full-time
- Spanish
- Computer literacy
- Writing skills
Now Hiring School Based Speech Professionals (SLP CCC, SLP CFY, and SLPA) in Redding, CA
ProCare Therapy —Redding, CA
- $30 - $70 an hour
- Full-time
- School experience
- School
- Entry level
- Health insurance
- Dental insurance
Quick Apply
Delivery Specialist
O'Reilly Automotive Stores —Redding, CA
- $16.90 - $24.90 an hour
- Full-time
- Sales
- Merchandising
- Driver's License
- Employee stock purchase plan
- Health insurance
Quick Apply
Mental Health Rehabilitation Specialist
Remi Vista, Inc. —Redding, CA
- $19 - $22 an hour
- Full-time
- Background check
- Current TB test
- Pass drug screening
- Paid holidays
- Health insurance
Quick Apply
Clinical Pharmacist Specialist
Mercy Medical Center Redding —Redding, CA
- $69.57 - $103.49 an hour
- Full-time
- CPR Certification
- Psychiatry
- Bachelor of Science
Parts Specialist
O'Reilly Automotive Stores —Anderson, CA
- $16.90 - $24.90 an hour
- ASE Certification
- Merchandising
- Cleaning
- Employee stock purchase plan
- Health insurance
Quick Apply
Recreation Specialist/Recreation Instructor I/Recreation Crew Supervisor: Aquatic Center - Aquatics
City of Redding —Redding, CA
- $17.75 - $27.13 an hour
- Part-time
- 18 years or older
- CPR Certification
- Current TB test
- Disability insurance
- Health insurance
Psychiatry Physician (TMS Specialist) - Physician Practice Ownership Opportunity
MedCBO —Redding, CA
- Hybrid work
- Medicine
- Psychiatry
- BC/BE
Quick Apply

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Transportation Specialist I - Sunday - Thursday 11:00am - 7:30pm

Partnership HealthPlan of California -
Redding, CA

Apply Now

Job Details

Full-time
$27.56 - $32.38 an hour

Qualifications

Computer literacy
Employee relationship building
High school diploma or GED
Typing
Quality data entry
Customer data entry

Full Job Description

Overview:

To facilitate access to medical care by coordinating Non-Emergency Medical (NEMT) Transportation, Non-Medical Transportation (NMT) transportation and travel-related benefits for members. Coordinates care in collaboration with internal and external partners to help members overcome barriers to care created by lack of transportation.

Responsibilities:

Effectively communicate written and verbally with both members and providers.
Works directly with members, transportation providers and medical or social service facilities to coordinate appropriate level and timeliness of transports and travel-related services such as meals, lodging and flights within the DHCS guidelines and Partnership policies.
Support and assist members in the resolution of problems with their transportation or travel benefits. Investigates issues using critical thinking and resolves or escalates as necessary.
Uses customer service skills to manage member and provider complaints and file grievances or escalate as necessary.
Communicate immediate health issues to a clinical member of the Care Coordination team and assist as needed in problem resolution.
Communicate non-transportation related needs to the appropriate team for assistance.
Establish and maintain effective interpersonal relationships with all levels of health plan staff, other programs, agencies and the general public.
Verifies member’s eligibility and determines level of program benefit.
Verifies transportation drop-off/pick-up locations to ensure adherence with Medi-Cal guidelines and uses critical thinking skills to identify potential fraud, waste and abuse.
Elicit medical information from provider, consulting with HS/UM Clinical Staff as appropriate.
Contacts provider, verbally and/or in writing to pursue needed information necessary to determine appropriate level of care or authorizations.
Generates administrative denial letters timely as per Partnership Policy and Procedure
Validates member and driver information necessary to process gas mileage reimbursements
Documents all cases opened for Transportation in the appropriate platform or database, as
per protocol.
Routes calls as appropriate in a courteous and professional manner from the ACD phone line in the transportation call center.

Secondary Duties and Responsibilities

Serves as departmental back-up as directed by Manager/Director.
Participates in special projects and assignments as required
Working knowledge and understanding of health plan structure and program requirements.

Qualifications:

Education and Experience

High School diploma or equivalent required. One (1) year experience in the medical/clerical field; or equivalent combination of education and experience. Experience in phone based customer service.

Special Skills, Licenses and Certifications

Excellent oral communication with problem solving skills. General knowledge of managed care. Ability to work within an interdisciplinary team structure and function in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Effective telephone and computer data entry skills required. Ability to access data and information using automated systems. Bilingual skills in Spanish, Tagalog, or Russian are preferred.

Performance Based Competencies

Excellent written and verbal communication skills. Ability to follow established procedures and protocol. Ability to communicate effectively with coworkers, physicians, and health care providers.

Work Environment And Physical Demands

Daily use of telephone and computer for most of the day. Standard cubicle work station with a shared common area. Ability to use a computer keyboard. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs.

All HealthPlan employees are expected to:

Provide the highest possible level of service to clients;
Promote teamwork and cooperative effort among employees;
Maintain safe practices; and
Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$27.56 - $32.38

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

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eligibility specialist jobs in redding, ca

Transportation Specialist I - Sunday - Thursday 11:00am - 7:30pm

Now Hiring School Based Speech Professionals (SLP CCC, SLP CFY, and SLPA) in Redding, CA

Delivery Specialist

Mental Health Rehabilitation Specialist

Clinical Pharmacist Specialist

Parts Specialist

Recreation Specialist/Recreation Instructor I/Recreation Crew Supervisor: Aquatic Center - Aquatics

Psychiatry Physician (TMS Specialist) - Physician Practice Ownership Opportunity

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