HybridHybrid flex schedule; work in the community and at offices in San Francisco, San Mateo, and Marin County, or from home.
Medical, Clinical & VeterinaryClinical Support & Patient Administration
About the job
Requirements
Ability to develop standard business communications using proper grammar, spelling, and punctuation.
Ability to convey complex information and ideas clearly, concisely, and professionally.
Ability to operate basic office equipment, including scanners, copiers, fax machines, and phones.
Basic familiarity with Microsoft Word, Excel, PowerPoint, Outlook, or similar software applications.
Ability to use an internal records system.
Ability to type 60 words per minute.
Discretion and ability to maintain confidentiality.
Basic understanding of health insurance billing and terminology, including co-payments, coinsurance, deductibles, and evidence of benefit.
Associate degree or equivalent required.
Knowledge of administrative and clerical procedures and systems, managing files and records, designing forms, and office procedures and terminology.
Responsibilities
Coordinate and process caregiver reimbursements for out-of-pocket expenses incurred for services for an individual enrolled in the GGRC Early Start program.
Work with caregivers to obtain documents from their health insurance company needed for reimbursement by GGRC.
Partner with service coordinators and the vendorization unit to complete the reimbursement process.
Submit purchase of service authorizations for caregiver reimbursement.
Review individuals’ eligibility for service reimbursement.
Communicate with caregivers verbally and by email regarding insurance coverage for the child’s early intervention services listed in the individualized family service plan.
Review and analyze insurance documents, including evidence of benefit statements, invoices, and service receipts.
Ensure compliance with policies and guidelines stated by the Department of Developmental Services.
Maintain client information confidentially in compliance with HIPAA and the California Lanterman Act.
Review the service page of the individualized family service plan.
Communicate with insurance claims departments to obtain needed documents.
Coordinate with the GGRC vendorization unit on the caregiver reimbursement process.
Manage the purchase reimbursement email inbox.
Respond to caregiver and service coordinator inquiries.
Educate caregivers on the Early Start purchase reimbursement process.
Work with the Clinical Operations Manager on cases requiring managerial guidance.
Identify and track reimbursement requests and their corresponding fiscal-year due dates.
Track case statuses.
Prepare copay worksheets and assemble individual packets for submission to the GGRC vendorization unit.
Receive and coordinate new purchase reimbursement referrals from service coordinators.
Track and collect statistics and numbers for the Early Start quarterly dashboard for reporting purposes.
Desired Qualifications
A Bachelor of Arts degree is preferred.
Purchase Reimbursement Specialist
Salary Range: $47,618 - $57,141 Annually
GGRC is currently hiring for a Purchase Reimbursement Specialist. This role will coordinate and process caregiver reimbursements for out-of-pocket expenses incurred for services for an individual enrolled in the Golden Gate Regional Center (GGRC) Early Start program. Communicate and work with caregivers to obtain the needed documents from their health insurance company to be reimbursed by GGRC. Partner with service coordinators and the vendorization unit to complete reimbursement process. Submit purchase of service authorizations (POS) for caregiver reimbursement.
This is a Hybrid flex schedule role offering the opportunity to work in the community, from any of our offices located in San Francisco, San Mateo and Marin County and from the comfort of your own home.
What you’ll Do:
Review individual serve’s eligibility for service reimbursement
Communicate with caregivers verbally and via email regarding insurance coverage for the child’s early intervention services that are listed in the individualized family service plan (IFSP)
Review and analyze insurance documents such as evidence of benefit statements, invoices, and service receipts
Ensures compliance with policies and guidelines stated by the Department of Developmental Services (DDS)
Maintain all client information as confidential in compliance with the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the California Lanterman Act
Review service page of individualized family service plan (IFSP)
Communicate with insurance claims department to obtain needed documents
Submit purchase of service authorizations for caregiver reimbursement
Coordinate with Golden Gate Regional Center (GGRC) vendorization unit for caregiver reimbursement process
Manage purchase reimbursement email box
Respond to caregiver and service coordinator inquiries
Educate caregivers on purchase reimbursement process for Early Start
Work with Clinical Operations Manager for any cases that needs managerial guidance
Identify and track reimbursement requests and their corresponding fiscal year due date
Track case statuses
Prepare copay worksheet and assemble individual packets for submission to GGRC vendorization unit
Receive and coordinate new referrals for purchase reimbursements from service coordinators
Track, collect stats and numbers for Early Start quarterly dashboard for reporting purposes
Who You Are:
Written communication: ability to develop standard business communications, using proper grammar, spelling and punctuation
Oral communication: ability to convey complex information and ideas in a clear, concise, and professional manner
Ability to operate basic office equipment, including scanners, copiers, faxes, phones
Basic familiarity with MS Word®, MS Excel®, MS PowerPoint®, MS Outlook® or similar software applications
Ability to use internal records system
Ability to type 60 wpm
Use of discretion and ability to maintain confidentiality
Basic understating of health insurance billing and terminology such as co-payments, coinsurance, deductibles, and evidence of benefit
Associate Degree or equivalent, B.A Preferred
Basic understanding of health insurance billing and terminology
Knowledge of administrative and clerical procedures and systems, managing files and records, designing forms, and other office procedures and terminology
What are the benefits to working with GGRC?
We offer a comprehensive benefits package including Medical and Dental benefits with a generous employer contribution and additional employer paid Life, Disability and Vision coverage
10% employer contribution to a 403(b) retirement account to help you save for the future!
GENEROUS TIME OFF BENEFITS!!!
No really, we mean generous:
13 vacation days, 15 sick days, 11 paid holidays, 6 personal holidays, and up to 5 paid days for continuing education
What makes GGRC so special?
GGRC values diversity, we believe in creating an environment where people of all backgrounds can collaborate to find solutions to complex problems. We are community minded and passionate.
GGRC values each person as a full, robust, and unique individual and interacts with each person in a manner that is respectful and responsive. We endeavor to place each person at the center of his, her or their own life. We approach each person as an expert on his, her or their own life and identity with a clear and attentive inquiry into what is important to, as well as important for, that one person (whether coworker or person-served, family member or other stakeholder).
How to apply:
GGRC values diversity; people of all backgrounds are encouraged to apply. Please complete the application and submit your most recent resume. If you feel that the questions do not accurately capture what you have to offer Golden Gate Regional Center, you are also welcome to attach a cover letter. Applications are being reviewed on a rolling basis so we encourage you to submit yours soon. We look forward to reading your application.
Golden Gate Regional Center is an Equal Opportunity Employer.