Share Email Opening Title Prior Authorization Coordinator (520)  Category Patient Financial Services - 8210   Description JOB SUMMARY: Answer calls from physician offices, hospitals and patients using exemplary customer service skills. Accurately enter required information (non-clinical and structured clinical data) into computer database. Review structured clinical data matching it against specified medical terms and diagnoses or procedure codes (without the need for interpretation) and follow established procedures for authorizing request or referring request for further review. Call back providers with precertification numbers as needed and file completed precertification requests as per established procedures. Validate benefit coverage per established procedures. Maintain patient confidentiality as defined by state, federal and company regulations. Establish effective rapport with support service staff, customers, clients, patients, families and physicians and actively support departmental strategic plans and ensure successful implementation. Maintain cooperative working relationships with all UM departments and providers. QUALIFICATIONS: ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Associate can deliver required care/service appropriate to patients/customers. Initiates pre-certification process on all required outpatient hospital services and initiates rescheduling appointments as needed. Serves as a resource for inpatient certification as needed. Supports patient financial services with appeals and retro authorizations as needed. Collects and distributes appropriate registration and certification documents to pertinent hospital departments. Keys all required certification information into the hospital Meditech information system. Displays and maintains behavior which promotes good guest relations to patients, visitors, physicians, and co-workers. Initiates corrections of registration information upon review of admissions and services requiring pre-certification. Demonstrates ability to embrace and adapt to change and regularly initiates ideas to improve the efficiency and processes of the department. Performs similar or related duties as assigned. EXPECTED BEHAVIORS: Evidence of good grooming and professional conduct. Good communication skills both oral and written. Ability to maintain composure under stressful situations. Possess a sense of responsibility, initiative, honesty and confidentiality.   Position Requirements CERTIFICATION/LICENSE: Licensed Practical Nurse (LPN); Registered Nurse (RN) ADDITIONAL LICENSURE/CREDENTIAL REQUIREMENTS: RN or LPN graduate of accredited nursing program. Previous experience in Utilization Management preferred. ADDITIONAL EDUCATION AND EXPERIENCE REQUIREMENTS: RN or LPN graduate of accredited nursing program. Mandatory Continuing Education: Customer Service, Fire and Safety, Corporate Compliance (including Confidentiality), Infection Control, and education required by regulatory, accreditation bodies, scope of practice, and/or Hancock Regional Hospital.   Full-Time/Part-Time Full-Time   Shift Days   Sign-On Bonus   Resubmittal due to closure after 120 days open?   Exempt/Non-Exempt   Position Prior Authorization Coordinator (520)   Number of Openings 1   Exempt/Non-Exempt Exempt   Open Date 7/15/2020   Location Hancock Regional Hospital   About the Organization YOUR HEALTH IS OUR LIFE Hancock Health is an Indiana-based, full-service healthcare network serving Hancock County and the surrounding areas. Our health system includes Hancock Regional Hospital, Hancock Physician Network and more than 20 other healthcare facilities, such as wellness centers, women's clinics, family practices, and the Sue Ann Wortman Cancer Center. A Caring Community Partner Our goal at Hancock Health is simple: To give every person the personalized attention necessary for a happy, healthy life. Our mission, vision, and values embody this goal. OUR MISSION To be a Caring Community Partner by healing, improving health and wellness, alleviating suffering, and delivering acts of kindness one person at a time. OUR VISION To be nationally recognized for kindness in the delivery of excellent quality patient care, efficient and effective operations, the adoption of proven technologies, the creation of a positive workplace environment, and excellence in community service. OUR VALUES Exceptional | Honorable | Devoted | Reliable | Kind   EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.   This position is currently not accepting applications. To search for an open position, please go to http://HancockRegionalHospital.appone.com WE ALSO RECOMMEND Other Jobs Within Same Category Revenue Integrity Regulatory Analyst (755) in Greenfield, IN Posted on: 2/9/2024 [Apply Now] Other Jobs Within 60 Miles Payroll Specialist (257) in Greenfield, IN Posted on: 3/29/2024 [Apply Now] Resource Team RN (652) in Greenfield, IN Posted on: 11/3/2023 [Apply Now] Resource Team RN (652) in Greenfield, IN Posted on: 9/15/2023 [Apply Now] Director, Chaplaincy (120) in Greenfield, IN Posted on: 3/29/2024 [Apply Now] Assistant Chaplain (462) in Greenfield, IN Posted on: 4/12/2024 [Apply Now]

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