Administrative Skills, Analysis Skills, Billing, Case Management, Certified Coding Specialist (CCS), Clinical Information, Computer Skills, Documentation, Epic Systems, Financial Operations, Government, Maintain Compliance, Medi-Cal, Medical Office, Medical Records, Medical Terminology, Outpatient Care, PC (Personal Computer) Systems, Patient Care, Patient Care Authorizations, Problem Solving Skills, Project/Program Coordination, Regulatory Requirements, Systems Administration/Management, Typing, Utilization Management
Principal Admitting Worker 3249928
- Hourly pay: $50.88/hr
- Worksite: Leading medical institution (San Francisco, CA, 94158 - Onsite: 16-32 hours a month onsite)
- W2 Employment, Group Medical, Dental, Vision, Life, Retirement Savings Program, PSL
- 40 hours/week, 3 Month Assignment
A leading medical institution is seeking a Principal Admitting Worker to support high-volume authorization workflows. This role is responsible for securing treatment authorizations, managing complex accounts, and ensuring compliance with Medi-Cal and multi-payer requirements while working independently in a fast-paced environment.
Principal Admitting Worker Responsibilities:
- Manage end-to-end CCS authorization workflows, including submitting Service Authorization Requests (SARs), coordinating with all California CCS counties, and securing approvals for inpatient and outpatient services.
- Perform detailed account analysis by verifying patient demographics, clinical information, insurance eligibility, benefits, and coordination of benefits across complex multi-payer scenarios.
- Handle high-volume authorization workloads, including follow-ups, denials, escalations, and resolution of coverage issues while meeting financial and operational targets.
- Collaborate with case managers, providers, and external stakeholders, including CCS offices and medical directors, to resolve authorization and billing issues.
- Maintain accurate documentation and workflow management within EPIC/APeX systems while ensuring compliance with Medi-Cal, CCS guidelines, and regulatory requirements.
Principal Admitting Worker Qualifications:
- 3+ years of clerical experience, including 2+ years at an Admitting Worker level or comparable role.
- 5+ years of hands-on experience in authorization, financial clearance, or utilization review, with CCS authorization as a primary responsibility.
- Strong knowledge of Medi-Cal, CCS guidelines, government programs, and coordination of benefits across multiple payers.
- Proficiency with EPIC or APeX systems and experience managing authorization workflows and documentation.
- Experience in submitting SARs and working directly with CCS across multiple counties.
- ADT experience.
- Basic medical terminology knowledge and typing/computer proficiency (including PC systems and office tools).
Shift:
- Monday, Friday, 08:00 am- 4:30 pm.
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