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Certification Process Coordinator
2 months ago
Position Overview:
This role involves providing essential administrative support within the certification process. The individual will be responsible for gathering non-clinical and structured clinical data, ensuring compliance with service requirements, and maintaining accurate records.
Key Responsibilities:
- Conduct outgoing communications with healthcare facilities to confirm patient status, request discharge information, and manage clinical review processes.
- Facilitate the transfer of calls requiring clinical assessment to licensed professionals.
- Manage fax communications with hospitals regarding clinical reviews and discharge requirements.
- Document all activities meticulously in the Utilization Review (UR) system, ensuring clarity and accuracy in data entry.
- Perform scripted clinical screenings as directed, adhering to established policies and procedures.
- Verify provider network participation and clarify any discrepancies in non-clinical data.
- Notify healthcare providers of certification outcomes and generate certification letters post-screening.
- Collaborate with medical offices, hospital records departments, and case managers as necessary.
- Provide assistance to intake administrative staff as needed and undertake additional tasks as assigned.
Qualifications:
Education:
- High School Diploma or equivalent; additional post-secondary education is preferred, particularly in medical terminology.
Skills:
- Proficient in computer usage, data entry, and word processing; familiarity with multi-line telephone systems is advantageous. Bilingual abilities are a plus but not mandatory.
Experience:
- Previous experience in the healthcare sector, such as medical transcription, is desirable. Completion of relevant orientation programs and adherence to quality assurance standards is required.
Personal Attributes:
- A friendly and helpful telephone demeanor is essential. Strong proofreading skills and the ability to prioritize tasks effectively are necessary. The candidate should be capable of collaborating with various professional staff and providing clerical support as needed.
Hines & Associates Inc values dedicated individuals who are committed to enhancing the efficiency of healthcare administrative processes.
