Easterseals Southern California transforms lives every day. For over a century, Easterseals has championed inclusion and independence—delivering essential services like early childhood programs, autism services, employment and independent living support to more than 29,000 people each year. Through advocacy and education, we break barriers and create opportunities for the one-in-four Americans with disabilities. 

OVERVIEW OF POSITION: Under general supervision, works with participantsto obtain placement for ABA within our internal ABA servicesr or the Behavior Provider Network. Functions as the liaison between Behavior Servicesassociates, medical providers, and participants. Coordinates assignments,manages related communications, and ensures appropriate documentation iscompleted. Processes referrals received from internal Clinical CaseManager associates to be placed with BPN providers, providing appropriatedocumentation. Functions asliason between network providers and internal associates and departments,depending on the assistance needed and assists withupdating service programs, authorizations, and notes related to client activityin EMR system.

ESSENTIAL FUNCTION:

• Coordinates and processes physician referrals, reports and re-authorizations as directed by management. Communicates with medical providers, Behavior department associates and contracted Behavior Network providers to ensure appropriate participant assignments have been identified and necessary documentation for behavior services is complete.
• Assists CCMs with processing and sending referrals to network providers and providing supporting documents to initiate services.
• Updates EMR system with appropriate provider placement and authorization details for billing.
• Provides professional verbal and written communications with participants, associates, medical provider counterparts and managers to assure requested participant assignments are consistent with services provided. Prepares, submits, and/or presents data, reports and/or spreadsheets related to utilization- or productivity-related statistics, as required. Provides orientation, familiarization, instruction and assistance to Behavior Network and Behavior Provider Network associates.
• Provides requested documents and updates to network providers to ensure consistency and efficient services are provided.
• Supports internal team and network providers with understanding of authorizations and assignments.
• Runs and completes reporting processes to verify conracted hours, utilization, and productivity related statistics.
• Communicates, collaborates, and participates with Behavior Provider Network team during meetings, and events intended to improve the level of efficient and effective quality service being delivered and to achieve other Behavior Services initiatives.
• Participates and communicates during BPN team meetings to gain understanding of new and current department processes, provide updates and input to assist and improve daily operations.
• Assists with billing errors, inquiries, data entry, reporting procedures and maintenance of master file.
• Performs other duties as assigned.

EDUCATION:

Requires a High School Diploma, GED, or national equivalent.

EXPERIENCE:

• 1-2 years’ experience in an administrative/clerical environment where complex interactions require a sophisticated level of coordination, preferably in a clinical setting.

KNOWLEDGE, SKILLS, ABILITIES:

• Proficient in Microsoft Office (Word, Excel, Outlook), Windows-based applications, databases, and internet usage.
• Excellent organizational, decision-making, and verbal and written communication skills to be able to communicate effectively with all levels of associates, physician’s office personnel, and the general public.
• Ability to assist in efficient office operations, work independently, and as a team member.
• Ability to maintain customer-service orientation and professionalism in all interactions.
• Ability to exercise a high level of discretion in handling confidential information.
• Ability to prioritize and organize workload and be able to produce high-quality results with meticulous attention to detail.
• Ability to remain focused and flexible with shifting/changing priorities, heavy workload and tight deadlines.
• Ability to acquire an understanding of organization and department policies and practices.
• Ability to pass a post-offer physical examination and a TB test.
• Ability to provide proof of required vaccinations or positive titer showing immunity. A signed declination may be acceptable for certain vaccinations.
• Ability to obtain and maintain a criminal record/fingerprint clearance from the Department of Justice and Federal Bureau of Investigation per Easterseals of Southern California and/or program requirements.

Carrying/Lifting: Occasional / Up to 30 lbs.
Standing: Occasional / Up to 3 hours per day
Sitting: Occasional / Up to 3 hours per day
Walking: Occasional / Up to 3 hours per day
Repetitive Motion/Activity: Keyboard activity, telephoneuse, writing.
Visual Acuity: Ability to view computer monitor and read newsprint .
Travel: Ability to travel locally, 10% of the time.
Environmental Exposure: Frequent exposure to unpleasantor hazardous working conditions (noise, heat, dust, bodily fluids, etc.) 20-50% of work time.