Rady Children's Hospital San Diego Eligibility Tech II-100747 in San Diego, California
Under the general supervision of the Eligibility and Benefits Supervisor this position exists to maintain eligibility and benefits information in the EZ-Cap System. The incumbent will determine payor responsibility based on eligibility of the member and forward claims to the appropriate payor, internal claims department or individual billing provider. Ensures claims are forwarded to the appropriate payor in accordance with AB1455 guidelines. The EZ-Cap System supports all of the activities of the Managed Care Department. Examples include Utilization Management, Claims, Capitation, Data and Eligibility. The incumbent will work professionally and courteously with patients, doctors, insurance companies and various departments in order to obtain information.
High School Diploma, GED or foreign equivalent
1 year of Managed Care experience