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+ Position Summary

+ Under general supervision, performs a set of diverse clerical duties acquiring, processing and maintaining assorted information or materials related to an administrative function; supports the professional clinical staff by performing duties as assigned. Reviews and provides clinically necessary patient information to third party payors to obtain insurance authorizations for Mary Greeley to perform ordered services which supports financial stability of the organization.

+ Position Responsibilities

+ Unit Specific Position Responsibilities

+ Evaluates patient eligibility based on coverage and specific payer medical policy requirements for ordered services.

+ Collaborates with clinicians appeal process for denied authorizations.

+ Establishes and maintains a means for communicating and collaborating with clinicians, other team members and departments, as well as patients.

+ Serves as liaison between insurance companies and Mary Greeley Medical Center. Will use knowledge as well as clinician support to help resolve issues raised by insurance companies relating to prior authorization of treatment and care.

+ Verifies worker’s compensation cases with employers and secures appropriate billing information.

+ Performs other duties and responsibilities as assigned.

+ Performs prior authorization duties to: Pain Clinic, Wound Healing Clinic, Hyperbaric Oxygen Therapy, and Rehab and Wellness as assigned.

+ Prepare patient charts for the nursing and medical staff and maintains the charts to ensure that necessary forms and notes are included in the chart.

+ Maintains electronic patient schedule.

+ Manages telephone contacts throughout the Pain Medicine Clinic, Wound Healing Clinic, Hyperbaric Oxygen Therapy, and Rehab and Wellness as assigned.

+ Assures patients are scheduled appropriately for an appointment or procedure in the electronic medical record and communicates schedule changes to all applicable staff, physicians, and vendors.

+ Obtains necessary signatures for treatment consent, HIPAA acknowledgement, release of information to ensure that necessary forms and notes are available.

+ Provides Patient Rights and Responsibilities to patients.

+ Assists with patient transportation within the hospital if needed.

+ Collaborate effectively with other departments, providers, and third-party payors.

+ Maintains schedule, including any template changes necessary for clinic operations, including staff or provider required changes, daily.

+ Qualifications, Knowledge & Experience

+ Required Qualifications (Including any licensure, certification, education):

+ At least 18 years of age

+ Organizational Requirements:

+ Maintain stroke education per regulatory requirements.

+ Preferred Qualifications:

+ Highschool diploma or GED

+ Hands-only CPR competency

+ Required Knowledge, Skills & Experience:

+ Ability to deal tactfully with the public and staff and to handle confidential work with tact and discretion.

+ Operation of office equipment

+ Knowledge of spelling, punctuation and grammar, and basic math; knowledge of general office practices and procedures

+ Preferred Knowledge, Skills & Experience:

+ Understanding Safety Precautions with X-ray equipment

+ Experience in an Outpatient Nurse setting.

+ Experience in Microsoft Word and Excel.