Diagnosis Related Group (DRG) Coordinator jobs in Modesto, CA

Overview

Starting Hourly: $18.00 per hour 

Golden Bear Physical Therapy, a member of Therapy Partners Group, has been the premier provider for outpatient orthopedics serving the Central Valley, El Dorado County, and surrounding communities for over 40 years. We are known for providing the highest quality individualized care for our patients and our team of highly skilled physical therapists who are passionate about helping patients achieve their goals. 

Currently, we are looking for a full time Authorization Coordinator for our 305 Banner Ct location in Modesto. 

Responsibilities

ESSENTIAL ACCOUNTABILITIES

• Monitors and manages authorization dashboard to identify and work outstanding authorizations
• Accurately submits authorizations to the payor/insurance on file with all required supporting documents
• Performs timely follow-up on submitted authorizations
• Inputs authorizations accurately into patient account when received
• Make necessary corrections and/or additions to current authorizations
• Communicate with referring MDs and treating therapist for missing or needed information to complete or submit authorization request.
• Provides timely communication with clinic/treating therapist when authorization is not on file for an upcoming visit or authorization is denied.
• Scan/Upload all forms completed and approved/denied authorizations into patient chart
• Maintains detailed notes in patients’ electronic records of all communications and actions taken
• Daily follow-up and completion of tasks as required by workflow assignments
• Attempt to obtain retro authorization as needed
• Maintains HIPAA Compliance of PHI
• Performs other duties that may be assigned

Qualifications

Knowledge, Skills, and Abilities

• Thorough working knowledge Microsoft Office
• Ability to identify and problem solve
• Must be organized and able to manage multiple priorities
• Ability to communicate complex information in a well thought-out, easily understood manner, both orally and in writing in a variety of settings and styles
• Ability to communicate in an honest, direct, and professional manner, relating well to others to build rapport and effective relationships
• Ability to demonstrate active listening by asking clarifying questions, identify and share relevant information and solicit feedback from others and give and receive feedback objectively
• Ability to model a strong commitment to quality and cost-effective administration of TPG (Therapy Partners Group)
• Ability to identify and recommend improvements to assigned areas of functionality.

Education and Experience

     Education: High school diploma. Related experience in healthcare may substitute for up to two years of the education requirement. 

     Experience: The individual selected must have a minimum of 2 years of experience in health care or a similar industry.

Physical Requirements and Working Conditions

Requires prolonged sitting, some walking, bending, stooping, reaching, and stretching. Requires hand-eye coordination and manual dexterity sufficient to operate a keyboard, mouse, photocopier, telephone, calculator, and other equipment. Requires normal range of hearing and eyesight to record, prepare and present reports.

#LI-MS1

#tpgpt