Specialist-Patient Placement- FT days

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.
• Precertifies 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

Experience

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.

Education

Minimum Required

• Associates degree or equivalent years of work experience.

Preferred/Desired

• Bachelors degree or equivalent years of work experience.

Training

Minimum Required

Preferred/Desired

Special Skills

• Excellent communication skills. Advanced computer literacy skills.

Minimum Required

• Excellent communication skills. Advanced computer literacy skills.

Preferred/Desired

Licensure

Minimum Required

Preferred/Desired

• LPN or CMA