Specialist-Patient Placement
Role Overview
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.
Key Skills for This Role
Full Job Posting
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
- Associates degree or equivalent years of work experience.
- Bachelors degree or equivalent years of work experience.
- Training
- Special Skills
- Excellent communication skills. Advanced computer literacy skills.
- Licensure
- LPN or CMA
Preferred Qualifications
- Preferred/Desired
About BMH Memphis Hospital
Non-profit health system providing comprehensive patient care services.
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