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Pre-certification Specialist

4 months ago

Jefferson, United States Ashe Memorial Hospital Full time
Job DescriptionJob DescriptionSalary: Pay commensurate with experience.

At Ashe Memorial Hospital, we are driven by our Mission Statement, "To meet the needs of the community by delivering patient-centered, high quality health care."

 

Ashe Memorial Hospital is proud to be Voted Ashe's Best Place to Work 2022. Come be a part of our dynamic team; you'll join Ashe's 2022 Best Hospital, Best Surgeon, Best Physician, Best Nurse Practitioner, Best Nurse, and Best Medical Practice  This is your opportunity to make a large difference in a small community


Hours: Mon. - Fri., 1st Shift, maybe some evenings | No Supervisory Responsibilities | No Travel | Pay commensurate with experience


JOB SUMMARY: 


Responsible for scheduling of all procedures, registration activities, gathering and processing of patient demographic and insurance information. Responsible for securing complete and authenticated signed orders for scheduled procedures. Performs work with accordance to the mission, vision, and values of Ashe Memorial Hospital (AMH).


Minimum Job Qualifications:

 

Education: High School graduate or equivalent preferred.


Experience: Prefer 2 years of relevant clinical experience, to include patient access, registration, collections, insurance and/or pre-certification, or related experience in a medical environment.


 License/Certifications: None.


Language Skills: Ability to read and communicate effectively in English.

 

Other Skills:

  • Basic computer knowledge, keyboard skills
  • Knowledge of CPT Coding, ICD 9 Codes, and Medicare Reimbursement Issues preferred.
  • Knowledge of basic Medical Terminology.
  • Productive typing skills.
  • Positive service-oriented interpersonal and communication skills required.
  • Individual must be able to demonstrate to the age of the patient served on his/her assigned department.
  • Interpret the appropriate information needed to identify each patient’s requirements relative to their age-specific needs and to provide the care needed as described in the area’s policies and procedures.


ESSENTIAL FUNCTIONS:

  1. Receives scheduling information, and determines the need for physician signature, labs, certification, or any additional information.
  2. Reviews medical necessity and obtains addition diagnosis if applicable.
  3. Correctly pre-registers and schedule patients. Notifies patient of estimated liability and documents in patient’s account.
  4. Obtains/verifies current personal information.
  5. Communicates clearly and appropriately to patient regarding prep for procedure, instructions upon arrival, bring photo ID, and any necessary information related to visit. Sends out appointment notices to patient in a timely manner.
  6. Returns voicemail calls regarding scheduling appointments within 1 hour of message.
  7. Demonstrates good organization skills and functions well in stressful situations.
  8. Interacts professionally with customers (internal and external) by treating them with dignity and respect.
  9. Demonstrates excellent customer service skills, even in extreme circumstances.
  10. Maintains a good working relationship with department co-workers, other departments, physician offices, and external agencies.
  11. Displays a positive attitude toward work. Contributes positively to office morale. Demonstrates a teamwork temperament with all staff.
  12. Assists in care and maintenance of department equipment and supplies. Alerts supervisor to malfunction of equipment.
  13. Prepares medical records on new patients.
  14. Records all information, such as physicians’ orders and instructions on requisition.
  15. Answers telephone.
  16. Enters Imaging orders in Meditech RIS.
  17. Meets departmental registration and scheduling goals in accordance with policy and procedures.
  18. Assists department manager in any area as needed.
  19. Planning: Organizes and manages time effectively to optimize productivity. Meets departmental registration and scheduling goals in accordance with policy and procedures. Possess the ability to accept change in a positive manner and implement change with positive results. Demonstrates a positive image of Ashe Memorial Hospital as a caring and concerned organization at all times. Maintains composure in difficult situations. Uses best judgement to resolve patient problems or refer issues to department supervisor/manager. Answers phone calls from outside clinicians, requesting information. Takes requests from referring physicians scheduling procedures.
  20. Performs other duties as directed/required. Meets deadlines.


Must be willing to receive all required vaccinations (i.e., flu shot, etc.). All new employees working must be fully vaccinated as a condition of employment (unless the new hire has requested and received an exemption). Candidates for employment will be notified of this policy requirement prior to the start of employment. After receiving an offer of employment, new employees must provide proof of vaccination or request and receive an exemption before beginning work.


To apply, please fill out an application, attach a cover letter, and resume. Include gaps in employment and reasons for separation.

Criminal background check and pre-employment drug screen required upon conditional job offer.

 

***Benefits apply the 1st of the month following employment, per policy.***

*For full job description and benefits, please contact Human Resources.

 

Ashe Memorial Hospital is an equal opportunity employer and, as such, considers individuals for employment according to their abilities and performance.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care.  Employment decisions are made without regard to race, age, religion, color, sex, national origin, physical or mental disability, marital or veteran status, sexual orientation, genetic information, or any other classification protected by law. All employment requirements mandated by local, state, and federal regulations will be observed.