Specialist-Patient Placement
Job ID: 42491
Job Category: Nursing Support & Patient Care
Work Type: Full Time
Work Schedule: Days
Department: Centralized Patient Access Center
Facility: BMHCC System Services
Location: Memphis, TN
Overview
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.
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.
Pre-certifies 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
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.
Special Skills
Minimum Required
Excellent communication skills. Advanced computer literacy skills.
Licensure Description Minimum
Preferred/Desired LPN or CMA
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