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Department: C0288530 Family Medicine Center
Schedule: Full Time status
Shift: Days
Hours:
Hours Per Pay Period: 80.0
Salary Range: $13.04 - $19.00
Additional Shift Details:
Job Details:
  • Obtains accurate authorization and billing information to effectively authorize/pre-certify all patients entering Saint Joseph Regional Medical Center.  Provides third party benefit verification for identified patients and other issues regarding the responsibilities to the related care plans.  

     

    JOB DUTIES

    1.       Actively demonstrates the organization's mission and core values, and conducts oneself at all times in a manner consistent with these values.

    2.       Knows and adheres to all laws and regulations pertaining to patient health, safety and medical information.

    3.       Ensures all patients located on the Authorization SQL are worked daily.

    4.       Notifies physician offices via fax 24 hours after appointment is scheduled as a reminder that authorization is required before the procedure can be performed.

    5.       Calls physician office a day prior to procedure as a reminder that procedure will be rescheduled if an authorization is not received by designated time frame.

    6.       Calls the insurance company to verify the authorization on all rescheduled patients is correct for the new schedule date.

    7.       Performs insurance verification duties as assigned.

    8.       Handles all correspondence in a timely and appropriate manner.

    9.       Documents all authorization information on all accounts, both online and in account notes.

    10.   Assists manager in working claims returned as "denied" for no authorization.

    11.   Assumes responsibilities in Appointment Center as staffing needs require for scheduling or pre-registration processes.

    12.   Performs other duties consistent with the purpose of job as directed. 

     

     

    JOB SPECIFICATIONS AND CORE COMPETENCIES

    Education: High school education required. Some post secondary education preferred specifically in business or healthcare.

    Licensure: CHAA required.

    Experience: Three to five year experiences in health care or insurance setting.  Interpersonal skills necessary to negotiate in high-stress situations when representing the Hospital in legal and adversarial situations.  Working knowledge of third party payer regulations, requirements, and laws governing admissions/registration procedures.  Proficient in medical terminology, word processing and spreadsheet applications.  

    Other Job Requirements:

    Ability to read, analyzes, and interprets Medicare compliance regulations.

    Ability to calculate figures and amounts such as discounts, co-insurance, co-pays and deductibles.

    This position requires a professional appearance.

    Superb customer service skills required over the phone and in person.

    Must be able to travel to all patient access sites. 

    Performs job responsibilities to the highest standards and delivers "something more" that ensures a more complete and personally satisfying experience for every customer.

    Must be willing to participate in continuing education seminars as related to patient access.

    Assigned hours within your shift, starting time, or days of work are subject to change based on departmental and/or organizational needs.

     

     

    ~CB~

    MON-MIS


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