Specialist-Patient Placement

Job Summary

Recommends the most efficient cost-effective utilization of resources within the continuum of care prior to the delivery of services. Evaluates assesses plans and facilitates a plan of care. Obtains/Validates insurance prior authorizations and pre-certification for inpatient and/or outpatient healthcare services. Some overtime and call back is required. This position is under the general direction of the leadership of Centralized Patient Access or Baptist Connected Center-Corporate. Performs other duties as assigned.

Responsibilities

• Assesses and evaluates clinical and financial information available and recommends the most appropriate setting for service delivery including level of care in order to optimize resource consumption and reimbursement.
  
  
  Pre-certifies patient care services that require precertification as identified in a timely efficient manner in order to optimize reimbursement for the patient as well as health care providers.
  
  
  Communicates recommendations clinical information and fiscal information to appropriate internal and external customers in order to facilitate optimal delivery of services and customer satisfaction.
  
  
  Participates in the planning data collection and analysis phases of performance improvement activities in order to maximize the patient placement/precertification process.
  
  
  Completes assigned goals.

Specifications

Minimum Required

• 5 years of business/clinical experience in a healthcare setting with a focus in patient access business office and/or case management areas.

Preferred/Desired

• 8 years of business/clinical experience in a healthcare setting with a focus in patient access business office and/or case management areas.
• High School Diploma required RHIT or LPN preferred 2 yrs college preferred Computer literacy and medical terminology required.

Education

• Associates degree or equivalent years of work experience.
  Bachelors degree or equivalent years of work experience.
  
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Special Skills

• Excellent communication skills. Advanced computer literacy skills.
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Minimum Required

• Working knowledge of Excel 2007 and Microsoft Office products. Comfort with data entry within Revenue Cycle software patient management systems and Windows based applications preferred.

Licensure

Minimum Required

Preferred/Desired

• LPN or CMA