Specialist-Patient Placement

Baptist • Jackson, MS

6d

About The Position

Recommends the most efficient, cost-effective utilization of resources within the continuum of care prior to delivery of services. Evaluates, assesses, plans, and facilitates a plan of care. Obtains and validates insurance prior authorizations and pre-certification for inpatient and/or outpatient healthcare services. Some overtime and call back is required. This position is under the general direction of the leadership of Centralized Patient Access or Baptist Connected Center-Corporate. Performs other duties as assigned.

Requirements

• At least 5 years of business/clinical experience in a healthcare setting focused on patient access, business office, and/or case management areas.
• Associate degree or equivalent years of work experience.
• Excellent communication skills.
• Advanced computer literacy skills.

Nice To Haves

• 8 years of business/clinical experience in a healthcare setting focused on patient access, business office, and/or case management areas.
• Bachelor’s degree or equivalent years of work experience.
• LPN or CMA.

Responsibilities

• Assesses and evaluates available clinical and financial information and recommends the most appropriate setting and level of care to optimize resource consumption and reimbursement.
• Precertifies identified patient care services that require precertification in a timely, efficient manner to optimize reimbursement for patients and healthcare providers.
• Communicates recommendations, clinical information, and fiscal information to appropriate internal and external customers to facilitate optimal service delivery and customer satisfaction.
• Participates in the planning, data collection, and analysis phases of performance improvement activities to maximize the patient placement/precertification process.
• Completes assigned goals.
• Obtains and validates insurance prior authorizations and pre-certification for inpatient and/or outpatient healthcare services.
• Performs other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Education Level: Associate degree