Summary

Recommends the most efficient, cost effective utilization of resources within the continuum of care, prior to the delivery of services. Evaluates, assesses, plans, and facilitates a plan of care. Obtains/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 Supervisor/Manager of Centralized Patient Access Center-Corporate. Performs other duties as assigned.

Responsibilities

• Assesses and evaluates clinical and financial information available and recommends the most appropriate setting for service delivery, including level of care in order to optimize resource consumption and reimbursement.

• Precertifies patient care services that require precertification, as identified, in a timely, efficient manner, in order to optimize reimbursement for the patient, as well as health care providers.

• Communicates recommendations, clinical information, and fiscal information to appropriate internal and external customers in order to facilitate optimal delivery of services and customer satisfaction.

• Participates in the planning, data collection, and analysis phases of performance improvement activities in order to maximize the patient placement/precertification process.

• Completes assigned goals.

Requirements, Preferences and Experience

Education

Preferred: Bachelors degree or equivalent years of work experience.

Minimum: Associates degree or equivalent years of work experience.

Experience

Preferred: 8 years of business/clinical experience in a healthcare setting with a focus in patient access, business office, and/or case management areas.

Minimum: 5 years of business/clinical experience in a healthcare setting with a focus in patient access, business office, and/or case management areas.

Licensure, Registration, Certification

Preferred: LPN or CMA

Special Skills

Minimum: Excellent communication skills. Advanced computer literacy skills.

About Baptist Memorial Health Care

At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.

At Baptist, We Offer:

• Competitive salaries

• Paid vacation/time off

• Continuing education opportunities

• Generous retirement plan

• Health insurance, including dental and vision

• Sick leave

• Service awards

• Free parking

• Short-term disability

• Life insurance

• Health care and dependent care spending accounts

• Education assistance/continuing education

• Employee referral program

Job Summary:

Position: 10514 - Specialist-Patient Placement

Facility: Centralized Patient Access Center

Department: HS Centralized Patient Access Ctr Corporate

Category: Nursing Support & Patient Care

Type: Non Clinical

Work Type: PRN

Work Schedule: Days

Location: US:TN:Collierville

Located in the Memphis metro area REQNUMBER: 21990