MAIN FUNCTION: Works within a team environment pre-authorizing infusion patient treatments, and registration of infusion patients.
Duties and Responsibilities: Communication: 1.
Promptly answers the telephone in a professional and courteous manner.
2.
Demonstrates the knowledge and ability to utilize various computer networks and telephone applications to procure pre-authorizations for patients.
3.
Demonstrates the ability to complete preauthorization’s in a timely manner.
4.
Demonstrates the ability to communicate courteously and effectively with internal and external customers.
5.
Demonstrates and understanding of both CPT, ICD10, and medical terminology.
6.
Demonstrates the ability to check appointment schedules daily to ensure that patient treatments have been preauthorized by the insurance carrier.
Clerical: 7.
Demonstrates insurance knowledge.
8.
Demonstrates knowledge of ICD 10.
9.
Demonstrates knowledge of Medicare requirements for approved ICD10 codes and to communicate to the provider when a code is not approved, and knowledge of Medicare waivers.
10.
Demonstrates the ability to accurately preauthorize/ pre-certify patient infusions/treatments.
11.
Demonstrates the ability to ability to be cross-trained to other responsibilities of the department as required by the supervisor/director.
12.
Responsible for accurate registration of all infusion patients while maintaining regulatory and functional knowledge of all information required to register patient types in database which ensures timely & accurate reporting/billing.
13.
Responsible for distribution of patient related materials and obtaining patient or designees signature on all necessary consents, permits, financial forms, as well as charity application, when applicable.
14.
Responsible for order entry, including but not limited to laboratory, physicians services as applicable to assigned area.
Proper reconciliation of appropriate ordered services may require contact with applicable department.
Reconciliation is required to be conducted timely and accurately with zero lose in revenue to system.
15.
Is responsible to acquiring precertification status on all applicable services; infusion treatments.
Computer: 16.
Demonstrates basic computer skills.
17.
Demonstrates the knowledge and ability to work within the Arnot Health’s computer System.
18.
Maintains computer security.
Working Relationship: 19.
Has general knowledge of hospital departments and how they interact with each other.
20.
Interacts with physician and physicians’ offices in a positive and courteous manner.
21.
Establishes and maintains collaborative working relationships with other health team members.
Quality: 22.
Demonstrates reliability in the conscientious, complete and accurate manner in which work assignments are preformed.
23.
Demonstrates quality improvement principles in daily work and participates in QI monitoring and reporting.
Quantity: 24.
Demonstrates flexibility in work schedule to meet the needs of the department 25.
Demonstrates the ability to perform multiple tasks as required by the position.
26.
Continuously utilizes time to maximize full potential, sets priorities and uses good organization skills.
Safety: 27.
Functions within an awareness of risk management and safety issues, reports concerns appropriately.
28.
Maintains complete understanding of Arnot Health’s Emergency Codes.
Professionalism: 29.
Is accountable for own actions 30.
Maintains and respects patients and patient confidentiality 31.
Maintains and respects patients and patient confidentiality 32.
Addresses internal and external customers in a pleasant and respectful manner, displaying courtesy at all times.
33.
Attends staff meetings.
Other: 34.
Is responsible for attending all annual mandatory education programs as required by position 35.
Employee understands and demonstrates the importance of satisfying the needs of the customer/patient by interacting with him/her in a friendly and caring way, being attentive to the customers’ needs, both psychologically and physically, and by taking the initiative to maintain communication with the customer in order to provide and pleasant experience with Arnot Health.
36.
In order to provide the highest quality of care to our patients individuals may be required to word beyond normal scheduled shifts will be required to comply with the systems attendance policy.
37.
It is understood that the Job description lists typical duties for classification and is not to be considered inclusive of all duties that that may be assigned.
EDUCATION: High School Diploma or Equivalent EXPERIENCE: A minimum of six months prior healthcare, finance, collection or billing experience preferred.
Clinical experience in ICD 10/CPT coding certification.
CARDIOPULMONARY RESUSCITATION (CPR) REQUIREMENTS: No CPR required PHYSICAL DEMANDS: Light physical effort.
Typical office job EXPOSURE CATEGORY: Category III.
Tasks that involve no exposure to blood, body fluids, or tissues.
Category I tasks are not a condition of employment.