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Prior Authorization Specialist-Neurology - Springfield, United States - Bon Secours Mercy Health
Description
At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence.Patient Services Specialist
Responsible for all aspects of scheduling, pre-registration and financial clearance functions associated with the respective specialty procedures.
Respond to heavy call volume from various sources to include patients, physicians, hospitals and other professionals in the medical field.
Responsibilities include collection and validation of accurate patient demographic and insurance information, obtaining pre-certification/authorization, scheduling for inpatient and outpatient services, and entering information into multiple outpatient and inpatient systems, serving as primary liaison with the patient, physician and hospital related to financial aspect of services.
Perform tasks which allows the physician to optimize service to the patient to include rooming patients for office visits and mediation refill.
Initiate getting information form the patient and to the patient with regards to surgery. Enter surgery information into EPIC for appropriate billing.Mission/Core Values:
It is expected that all of the duties and responsibilities of this position will be performed in a manner consistent with Mercy Health's Standards of Behavior (CARE; Compassion: seeks to understand, listen and explain; Advocate: is the voice for the vulnerable; Respect: demonstrates the highest regard for and welcomes all people; Excellence: commits to the highest standard of quality care, joyful service, and teamwork) and in a manner that reflects the core values of Mercy Health which are: Excellence, Human Dignity, Justice, Compassion, Sacredness of Life and Service.
All supervisors and above are expected to model the organizational mission and values through their daily actions, decision making and priority setting.
All supervisors and above are expected to develop, implement and monitor short and long range plans to meet or surpass standards consistent with the overall strategic plan.
ESSENTIAL FUNCTIONS
Administrative job duties:
Physician correspondence, transcription - narrative reports, letters of recommendation for MD. Schedule and confirm business meetings, arrange business related travel/accommodations and course registrations and organize business receipts. Record CME/DEA/State License. Maintain weekly schedule and appointment schedule and coordinate call schedule and coverage. Communicate with appropriate staff/manager when physician is out of office.
Patient related non clinical job duties: Answer all patient calls within 24 hours.
Schedule inpatient and outpatient services and initiate the verification and pre-auth process.
Review benefits, cost and coverage with patients to assess financial liability and answers questions and verify demographic and insurance information.
Enter information into both inpatient and outpatient systems including surgery charge entry within 48 hours. Primary liaison for patient, MD and hospital for financial aspect of services. Assist MD with denials and appeals process. Manage patient calls and communicates patient issues with appropriate department and triage call consults. Print and scan medical documentation into EPIC and assist with patient forms to include completion of Medco 14. Ensure all pre-op requirements have been completed: surgeries, pre-admission testing, scheduling outside medical evaluations, and pre-op teaching class.Coordinate equipment orders for surgical patients, assists with patient medication refills, complete bracing and orthotic paperwork, maintain research records and outcomes.
The above is intended to describe the general content and functions of this job. It is not to be construed as an exhaustive list of all duties or responsibilities. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation. The job description is subject to continual revisions as needed for patient care.Due to the services and care provided by this institution, personnel may be requested to serve in related capacities as determined by their qualifications in a different unit, department, and campus, in an effort to not disrupt patient care and continue to provide a safe environment to our patients.
All employees are expected to follow Mercy Health policies and procedures, maintain high standards of safe work performance, and maintain good attendance and punctuality.
MINIMUM EDUCATION
Required Minimum Education:
High School Diploma
Many of our opportunities reward* your hard work with:
Comprehensive, affordable medical, dental and vision plans
Prescription drug coverage
Flexible spending accounts
Life insurance w/AD&D
Employer contributions to retirement savings plan when eligible
Paid time off
Educational Assistance
And much more
*Benefits offerings vary according to employment status
All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability.
If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health - Youngstown, Ohio or Bon Secours - Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email .
If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at
