Patient Advocate/Coordinator - Perinatology - 32 Hours/Week

Why work for Nebraska Methodist Health System
At Nebraska Methodist Health System we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care a culture that has and will continue to set us apart. Its helping families grow by making each delivery special conveying a difficult diagnosis with a compassionate touch going above and beyond for a patients needs or giving a high five when a patient beats a disease or conquers a personal health challenge. We offer competitive pay excellent benefits and a great work environment where all employees are valued! Most importantly our employees are part of a team that makes a real difference in the communities we live and work in.

Job Summary:

Responsibilities:

Essential Functions

Serves as a patient advocate by encouraging collaboration between Hospital departments and external agencies on behalf of the patient to enable patient/family to take full advantage of services which may be of service to them.

• Contact all new patients to establish relationship. Provide specific information relating to hospital based status billing process and other services available.
• Ensure appropriate account is opened in accordance with organizational policies to include correct demographics payer and guarantor information.
• Ensure preauthorization/referral from insurance carrier/Primary Care Provider (PCP) is obtained prior to services rendered in the outpatient and inpatient units.
• Documentation of all interactions to be maintained in patient Health Information System.
• Communicate status of referral information prior to patient visit parameters discussed with physicians and other caregivers

Maintains up to date knowledge of system plan codes and third party payer authorizations/referrals. Account management appropriate plan selection and responsibility for third party payer authorizations/referrals.

• Responsible for reviewing communications from Managed care departments to facilitate implementation into current process for purposes of accurate plan code selection administering denials due to no authorizations referrals etc.
• Responsible for reviewing communication received directly from insurance companies regarding benefit changes authorization.
• Maintains knowledge of various payer tools and payer requirements related to method to obtain authorizations and referrals including obtaining required information via the payer websites telephone and/or fax.
• Maintains knowledge of various payer requirements related to method to the need to submit procedure information via Current Procedural Terminology (CPT) International Classification of Disease (ICD) or Healthcare Common Procedure Coding System (HCPPCS) coding versus written descriptions.
• Utilizes International Classification of Disease (ICD)-9 Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) books web tools literature searches and other resources as required to facilitate providing insurance companies with required information.
• Works directly with physicians and other caregivers to obtain required information to facilitate the appropriate authorization/referral for procedure performed.
• Documents all transaction into the patient information systems.
• Organizes and prioritizes resources to provide efficient processing of patient/customer/departmental needs and cost containment and recycling. Puts the customer first in all interactions.
• Effectively utilizes time to provide efficient customer service during work hours gains pre-approval for overtime.

Schedule:

4 eight hour shifts each week. Shift times may vary 6:45a-3:15p 7:30a-4p or 8a-4:30p. No Weekends/Holiday

Job Description:

Job Requirements

Education

• High School Diploma or General Educational Development (G.E.D) required

Experience

• Minimum three years experience in physician office or hospital outpatient environment required.
• Experience in coding compliance or third party payer required.

License/Certifications

• Certified coding specialist preferred.
• Certified professional coder preferred.

Skills/Knowledge/Abilities

• Demonstrated verbal and written communication skills required.
• Demonstrated approach to problem solving and professionalism in decision making skill required.
• Demonstrated ability to work as part of a team approach to patient care required.
• Ability to meet deadlines and works with minimum supervision required.
• Knowledge of telecommunications system policy and procedure manuals general office materials/equipment computers required.

Physical Requirements

Weight Demands

• Medium Work - Exerting up to 50 pounds of force.

Physical Activity

• Occasionally Performed (1%-33%):
  • Climbing
  • Crawling
  • Kneeling
  • Sitting
• Frequently Performed (34%-66%):
  • Balancing
  • Carrying
  • Crouching
  • Distinguish colors
  • Keyboarding/typing
  • Lifting
  • Pulling/Pushing
  • Repetitive Motions
  • Standing
  • Stooping/bending
  • Twisting
  • Walking
• Constantly Performed (67%-100%):
  • Fingering/Touching
  • Grasping
  • Hearing
  • Reaching
  • Seeing/Visual
  • Speaking/talking

Job Hazards

• Not Related:
  • Explosives (pressurized gas)
  • Electrical Shock/Static
  • Radiation Alpha Beta and Gamma (particles such as X-ray Cat Scan Gamma Knife etc)
  • Radiation Non-Ionizing (Ultraviolet visible light infrared and microwaves that causes injuries to tissue or thermal or photochemical means)
• Rare (1-33%):
  • Chemical agents (Toxic Corrosive Flammable Latex)
  • Mechanical moving parts/vibrations
• Occasionally (34%-66%):
  • Biological agents (primary air born and blood born viruses) (Jobs with Patient contact) Blood or Body Fluid (BBF)
  • Physical hazards (noise temperature lighting wet floors outdoors sharps) (more than ordinary office environment)
  • Equipment/Machinery/Tools

About Methodist:

Nebraska Methodist Health System is made up of four hospitals in Nebraska and southwest Iowa more than 30 clinic locations a nursing and allied health college and a medical supply distributorship and central laundry facility. From the day Methodist Hospital was chartered in 1891 service to our communities has been a top priority. Financial assistance health education outreach to our diverse communities and populations and other community benefit activities have always been central to our mission.

Nebraska Methodist Health System is an Affirmative Action/Equal Opportunity Employer and does not discriminate on the basis of race color religion sex age national origin disability veteran status sexual orientation gender identity or any other classification protected by Federal state or local law.