Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to DE&I combines a focus on our people processes and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in - join us!
Your Role
The Blue Shield Promise Health Clinic team is responsible for providing comprehensive, communicative, and collaborative healthcare to our members that is of the quality that we would want for our own family members The Medical Assistant -Advanced will report to the Clinic Operations Supervisor. In this role you will be the initial point of contact for providers and members in the medical management process by telephone or correspondence, assist with ensuring members are effectively and efficiently managed through the medical/disease management process as needs require. Works cohesively with medical professionals to ensure continuity of care for members. Process authorization requests and facilitates referrals. Assists with system letters, requests for information and data entry. Provides administrative/clerical support to medical and disease management.
This role is specific to our pediatric patients and will support our pediatrician and his team. As an advanced member of our team, you should have 3-5 years' experience in a pediatric environment.
Your Work
In this role, you will:
Greet Patients.
Record Patient Vitals- height, weight, length.
POC Testing (Specifically for PEDS).
Lead Testing.
Stock and clean exam rooms.
Experience with VFC and CAIR System and vaccine administration.
Exceptional interpersonal skills to support and reassure pediatric patients and their families.
Excellent written and verbal communication skills.
Process faxed/phoned in authorizations, UM/CM requests, special processing/case types and/or calls left on voicemail.
Data entry including authorization forms, high risk member information, verbal HIPPA authorizations information for case creation.
Respond to inquiry calls on as needed.
Advance cases to senior staff.
Research member eligibility/benefits and provider networks.
Works to deliver on day-to-day objectives with direct impact on achievement of results for the job area.
Work consists of tasks that are typically routine, with some deviation from standard practice.
Works under moderate supervision for routine tasks. May seek advice of more senior personnel in the same area. Keep supervisor informed of issues, activities, progress and problems.
Checks and makes minor adjustments to work methods to solve problems that are routine and typically exist in current work processes and systems. May be required to highlight areas of concerns/problems and put forth solutions to supervisor in own job area.
Problems and issues faced are generally routine but may require some interpretation of procedures or policies to resolve problems.
Communicates with contacts typically within the job area on matters that involve obtaining or providing information requiring some explanation or interpretation to reach agreement.
May provide guidance and assistance to new or entry-level employees.
Perform record audits.
Maintain accurate logs, card files, statistics, and information release forms for providing medical record.
Your Knowledge and Experience
Requires a high school diploma or equivalent.
Requires at least 5 years of prior relevant experience.
Prior work experience in a pediatric office 3-5 years.
Bilingual a plus.
Our Values
Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
Human. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Additional Information
About Company: At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We*re excited to share Blue Shield of California has received awards and recognition for * LGBT diversity, quality improvement, most influential women in corporate America, Bay Area*s top companies in volunteering & giving, and one of the world*s most ethical companies. Here at Blue Shield of California, we*re striving to make a positive change across our industry and the communities we live in * Join us!
Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. Based in our physical offices and work from home office/deskwork * Activity level: Sedentary, frequency most of work day. Please click here for further physical requirement detail. "
EEO Footer: External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws. COVID-19 update: From the earliest days of the pandemic, Blue Shield of California has been unyielding in our commitment to putting the health and safety of our people, our members and our communities first. As a federal contractor and a health care company, Blue Shield requires all employees to be fully vaccinated prior to start date as a condition of employment and provide proof of vaccination status. Blue Shield will consider requests for medical or religious accommodation to this vaccination requirement prior to your start date
