Business Office Coordinator, Jordan Valley Senior Care (JVSC) PACE

About the role

Jordan Valley Health (JVH) is a mission-driven organization dedicated to improving the health of individuals and families in underserved communities. We provide comprehensive healthcare services including primary medical, dental, vision, and behavioral health. Our mission is simple: Improve our community’s health through access and relationships. By working collaboratively with partners and continually innovating, JVH strives to be a leader in providing essential healthcare for the underserved, ensuring everyone in our community has access to quality healthcare.

Key Responsibilities

• Authorization Management

  • Initiate, track, and manage authorization requests for medical services, specialty care, diagnostics, DME, and ancillary services for JVSC participants.
  • Collaborate with the Medical Scheduler to obtain required clinical documentation to support authorization requests.
  • Maintain accurate authorization logs in the electronic health record (EHR) and billing systems.
  • Communicate authorization status updates to clinical and care management staff promptly.
  • Research and resolve claim denials in collaboration with the clinical team, initiating appeals as appropriate.

• Claims Review & Management

  • Review pended and denied claims on a daily and weekly basis to identify root causes and drive resolution.
  • Work with TPA, vendors/contractors, and JVSC leadership to resolve claim edits, coding errors, and missing information.
  • Analyze denial trends and prepare summary reports for leadership to support process improvement initiatives.
  • Collaborate with the IDT to obtain supporting documentation required for claim appeals.
  • Monitor accounts receivable aging reports and escalate unresolved claims as needed.

• Supply & Inventory Management

  • Manage ordering, receiving, and stocking of office supplies, clinical supplies, and medical equipment for JVSC.
  • Maintain an accurate inventory tracking system; conduct regular physical counts and reconcile discrepancies.
  • Identify cost-effective vendors and negotiate pricing or quantity discounts in coordination with JVSC leadership.
  • Monitor par levels and reorder points to prevent stockouts while minimizing excess inventory.
  • Collaborate with the Finance department to ensure accurate coding of all supplies.
  • Prepare reports for JVSC leadership on supply costs and trends.

• Contracting Support

  • In collaboration with the Health Plan Manager and Contracting team, assist in the development, review, and maintenance of provider and vendor contracts, including network specialist agreements and ancillary service agreements.
  • Track contract effective dates, renewal windows, and termination clauses; alert the Health Plan Manager in advance of critical deadlines.
  • Liaise with legal, compliance, and external partners during contract negotiation processes.
  • Support compliance reviews by providing contract documentation as requested.

• General Administrative & Compliance

  • Maintain confidentiality of participant health information in accordance with HIPAA regulations.
  • Participate in JVSC program audits, surveys, and compliance activities as assigned.
  • Attend IDT meetings and departmental meetings as requested.
  • Support the front office and other business office functions during periods of high volume or staff absence.
  • Support the Health Plan Manager and IDT in coordination of participant assistance (e.g. spenddowns, spend cards, utility assistance, etc.) as indicated.
  • Promote the education and development of students, interns, residents, apprentices, and other new staff by sharing expertise, responding to questions, and fostering a positive and supportive learning environment.
  • Perform other duties as assigned by JVSC leadership.

Benefits

• Medical and Prescription Drug Coverage:

  • Three comprehensive plan options (Buy-up, Base, and High Deductible) through UnitedHealthcare's Choice Plus network, covering various deductibles and out-of-pocket limits.
  • Includes access to telemedicine services via Teladoc.

• Health Savings Account (HSA):

  • Available for employees in the High Deductible Plan with employer contributions and tax advantages.

• Flexible Spending Account (FSA):

  • Options for both healthcare and dependent care FSAs, allowing pre-tax contributions for qualified expenses.

• Dental and Vision Coverage:

  • Dental insurance through Cigna’s DPPO network and vision coverage through EyeMed’s Insight network.

• Retirement Plan:

  • Pre-tax and Roth 403(b) retirement plans with a 5% employer match starting after 30 days of employment.

• Life and Disability Insurance:

  • Basic Life and AD&D insurance provided at no cost, with the option to purchase additional coverage.

• Employee Assistance Program (EAP):

  • Free confidential support for personal and professional challenges, including counseling and crisis intervention.

• Additional Voluntary Benefits:

  • Options for critical illness, accident, hospital care, and pet insurance through MetLife.

Holidays

Nine paid holidays per year.

Health Requirements

All employees are required to provide proof of vaccination for Flu, Hepatitis B and Tuberculosis (TB) as part of our commitment to maintaining a safe and healthy workplace.