• Specialist-Patient Placement

    Baptist Memorial (Columbus, MS)


    Overview

    Job Summary

    Recommends the most efficient, cost effective utilization of resources within the continuum of care, priorto 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 ofCentralized Patient Access or Baptist Connected Center-Corporate. Performs other duties as assigned.

    Job 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.

    Experience

    Description Minimum Required Preferred/Desired

    5 years of business/clinical

     

    experience in a healthcare

     

    setting with a focus in patient access, business office, and/orcase management are

     

    setting with a focus in patient access, business office, and/orcase management areas.

    Education

    Description Minimum Required Preferred/Desired

     

    Associates degree or equivalent

     

    years of work experience.

     

    Training

     

    Description Minimum Required Preferred/Desired

     

    Special Skills

     

    Description Minimum Required Preferred/Desired

     

    Excellent communication skills.

     

    Advanced computer literacy

     

    skills.

     

    Licensure

     

    Description Minimum Required Preferred/Desired

     

    LPN or CMA

    REQNUMBER: 32317