Week - Days

Nebraska Methodist Hospital•Omaha, NE

4d•Onsite

About The Position

Why work for Nebraska Methodist Health System? At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care – a culture that has and will continue to set us apart. It’s helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient’s needs, or giving a high five when a patient beats a disease or conquers a personal health challenge. We offer competitive pay, excellent benefits and a great work environment where all employees are valued! Most importantly, our employees are part of a team that makes a real difference in the communities we live and work in. Job Summary: Location: Medical Office Building - MWH Address: 717 N 190th Plaza, Elkhorn, NE Work Schedule: Monday-Friday, Four - 8 hour shifts varying between 6:45am to 3:15pm, 7:30am to 4pm and 8am to 4:30pm, no weekends or holidays Works with hospital departments and external agencies on behalf of the patient to utilize services which may be of service to the patient.

Requirements

High School Diploma or General Educational Development (G.E.D) required
Minimum three years' experience in physician office or hospital outpatient environment required.
Experience in coding, compliance or third party payer required.
Demonstrated verbal and written communication skills required.
Demonstrated approach to problem solving and professionalism in decision making skill required.
Demonstrated ability to work as part of a team approach to patient care required.
Ability to meet deadlines and works with minimum supervision required.
Knowledge of telecommunications system, policy and procedure manuals, general office materials/equipment, computers required.

Nice To Haves

Certified coding specialist preferred.
Certified professional coder preferred.

Responsibilities

Serves as a patient advocate by encouraging collaboration between Hospital departments and external agencies on behalf of the patient to enable patient/family to take full advantage of services which may be of service to them.
Contact all new patients to establish relationship.
Provide specific information relating to hospital based status, billing process and other services available.
Ensure appropriate account is opened in accordance with organizational policies to include correct demographics, payer and guarantor information.
Ensure preauthorization/referral from insurance carrier/Primary Care Provider (PCP) is obtained prior to services rendered in the outpatient and inpatient units.
Documentation of all interactions to be maintained in patient Health Information System.
Communicate status of referral information prior to patient visit parameters discussed with physicians and other caregivers
Maintains up to date knowledge of system plan codes and third party payer authorizations/referrals.
Account management, appropriate plan selection and responsibility for third party payer authorizations/referrals.
Responsible for reviewing communications from Managed care departments to facilitate implementation into current process for purposes of accurate plan code selection administering denials due to no authorizations, referrals, etc.
Responsible for reviewing communication received directly from insurance companies regarding benefit changes, authorization.
Maintains knowledge of various payer tools and payer requirements related to method to obtain authorizations and referrals including obtaining required information via the payer websites, telephone and/or fax.
Maintains knowledge of various payer requirements related to method to the need to submit procedure information via Current Procedural Terminology (CPT), International Classification of Disease (ICD) or Healthcare Common Procedure Coding System (HCPPCS) coding versus written descriptions.
Utilizes International Classification of Disease (ICD)-9, Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) books, web tools, literature searches and other resources as required to facilitate providing insurance companies with required information.
Works directly with physicians and other caregivers to obtain required information to facilitate the appropriate authorization/referral for procedure performed.
Documents all transaction into the patient information systems.
Organizes and prioritizes resources to provide efficient processing of patient/customer/departmental needs and cost containment and recycling.
Puts the customer first in all interactions.
Effectively utilizes time to provide efficient customer service during work hours, gains pre-approval for overtime.