1

Healthhelp Jobs in California (NOW HIRING)

$24.26/hr

Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing). * Completes orders with proper documentation on where patient ...

Healthhelp information

What is the difference between Healthhelp vs Medical Billing Specialist?

AspectHealthhelpMedical Billing Specialist
CredentialsTypically requires healthcare or insurance-related certificationsRequires coding and billing certifications, such as CPC or CCS
Work EnvironmentHealthcare facilities, insurance companies, or third-party billing servicesMedical offices, hospitals, or billing companies
Industry UsageUsed in healthcare and insurance sectorsPrimarily in healthcare billing and coding
Job FocusManaging insurance claims, authorizations, and patient dataProcessing medical bills, coding diagnoses, and ensuring accurate billing

While both roles operate within the healthcare financial ecosystem, Healthhelp focuses on insurance authorizations and claims management, whereas Medical Billing Specialists handle billing and coding processes. Understanding these differences helps job seekers identify the right career path in healthcare administration.

What is Healthhelp and what do they do?

HealthHelp is a healthcare management company that provides specialty benefit management services for health plans and providers. They focus on improving patient outcomes and reducing unnecessary healthcare costs by using evidence-based guidelines and clinical expertise to review and authorize medical procedures, imaging, and other specialty services. HealthHelp partners with payers and providers to ensure that patients receive appropriate care while streamlining administrative processes. Their services often include prior authorization, clinical review, and education for both patients and healthcare professionals.

What are some common challenges faced when working at HealthHelp, and how can new employees prepare for them?

One common challenge at HealthHelp is adapting to the fast-paced environment and rapidly changing healthcare regulations. New employees should be prepared to handle high volumes of information and multi-task between various cases and systems. Effective communication and collaboration with clinical and administrative teams are essential, as the role often involves coordinating care and ensuring compliance. Proactively seeking feedback and utilizing available training resources can help new hires acclimate more quickly and perform confidently.

What are the key skills and qualifications needed to thrive as a Utilization Review Nurse at HealthHelp, and why are they important?

To excel as a Utilization Review Nurse at HealthHelp, you need a current RN license, strong clinical background, and expertise in medical necessity criteria and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of CMS regulations are typically required. Critical thinking, attention to detail, and effective communication are vital soft skills for collaborating with physicians and insurance providers. These competencies ensure accurate case evaluations, regulatory compliance, and optimal patient outcomes within managed care environments.
What are popular job titles related to Healthhelp jobs in California? For Healthhelp jobs in California, the most frequently searched job titles are:
Care Coordinator

$24.26/hr

Full-time

Re-posted 17 hours ago


ChenMed rating

8.4

Company rating: 8.4 out of 10

Based on 40 frontline employees who took The Breakroom Quiz

1st of 235 rated social care providers


Job description

We're unique. You should be, too.

We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?

We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.

The Care Coordinator is a highly visible customer service and patient-focused role that works directly with our patient population and their families, insurance representatives and outside vendors, physicians, clinicians and other medical personnel in a dynamic and professional environment to provide the highest level of quality healthcare to our members.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Coordinates and processes patient referrals to completion with precision, detail and accuracy.

Definition of completion:

  • Prioritizes HPP patients in Primary Care Physicians panel, stats, expedites and orders over 5 days.
  • Orders have been approved (when needed).
  • Schedules patient (Preferred Providers List of Specialist) and notifies them of appointment information, including, date, time, location, etc.
  • Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing).
  • Completes orders with proper documentation on where patient is scheduled and how patient was notified.
  • Referrals have been sent to specialist office & confirmed receipt.
  • Prepares and actively participates during physician/clinician daily huddles utilizing RITS Huddle Portal and huddle guide. Communicates effectively the physicians/clinicians needs or outstanding items regarding to patients.
  • Enters all Inpatient and Outpatient elective procedures in HITS tool.
  • Ensures patient's external missed appointment are rescheduled and communicated to the physician/clinician.
  • Participates in Super Huddle and provides updates on high priority patients referrals.
  • Addresses referral based phone calls for Primary Care Physicians panel.
  • Completes and addresses phone messages within 24 hours of call.
  • Checks out patients based on their assigned physician/clinician. (Note: If assigned Care Coordinator is unavailable at the time of check out, a colleague shall assist patient. This process does not apply to Care Specialist)
  • Retrieves consultation notes from the consult tracking tool.
  • Follows up on all Home Health and DME orders to ensure patient receives services ordered.
  • Provide extraordinary customer service to all internal and external customers (including patients and other
  • ChenMed Medical team members) at all times. Utilization of patient messaging tools.
  • Performs other related duties as assigned.

KNOWLEDGE, SKILLS AND ABILITIES:

  • Must be detail-oriented, possess the ability to multi-task and be open to cross-functionally training in referrals duties.
  • The individual in this role must exercise proper phone etiquette and have the ability to navigate proficiently through computer software systems.
  • Must be team-oriented and work extremely well with patients, colleagues, physicians and other personnel in a professional and courteous manner.
  • Exceptional organizational skills with the ability to effectively prioritize and timely complete tasks. Knowledge of medical terminology, CPT, HCPCS and ICD coding preferred.
KNOWLEDGE, SKILLS AND ABILITIES:
  • Knowledge of medical terminology, CPT, HCPCS and ICD coding desired
  • An understanding of the company's patient population, including the complexities of Medicare programs
  • Exceptional organizational skills with the ability to effectively prioritize and complete tasks in a timely manner.
  • An understanding of the company's patient population, including the complexities of Medicare programs
  • Detail-oriented with the ability to multi-task.
  • Able to exercise proper phone etiquette.
  • Ability to navigate proficiently through computer software systems & use technology.
  • Ability to work well with patients, colleagues, physicians and other personnel in a professional manner.
  • Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation software.
  • Spoken and written fluency in English; bilingual preferred.
EDUCATION AND EXPERIENCE CRITERIA:
  • High School diploma or equivalent required
  • A minimum of 1 year of referral experience in a healthcare setting required.
  • Experience with web-based insurance sites and obtaining referrals/authorizations for multiple payors preferred.
  • Experience with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred
  • Healthcare experience within the Medicare Advantage population preferred.
  • Medical Assistant certification preferred
  • CPR for Healthcare Providers is preferred

PAY RANGE:

$17.0 - $24.26 Hourly

The posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for a bonuses or commissions.

EMPLOYEE BENEFITS

https://chenmed.makeityoursource.com/helpful-documents

We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.

ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.

Current employees, if you want to apply to our internal career site, please click HERE

Current Contingent Worker please see job aid HERE to apply

#LI-Onsite

What ChenMed employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom


ChenMed logo

About ChenMed

Sourced by ZipRecruiter

We're expanding healthcare equity across America. We're already in 15 states with 100+ medical centers. As a rapidly growing, physician-led organization, we have one central focus: rescue any and every senior from a healthcare system that has failed them. Our family of brands include Chen Senior Medical Center, JenCare Senior Medical Center, and Dedicated Senior Medical Center. Recently named a 2021 Best Places To Work and one of the only healthcare companies recognized in Fortune's 2020 "Change The World" list, ChenMed prides itself on creating a culture that enables career growth and promotes inclusion for all.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Miami, FL, US

Year founded

1985

Social media