Overnight Prior Authorization Representative Express Scripts Jobs in Bessemer, AL

JOB SUMMARY 

Work Location: Brookwood Medical Center

Shift Information: Mon & Thursdays 6p-10p w/ rotating weekends 7:30a-8pm

Responsible for duties in support of departmental efficiencies which may include: but not limited to performing  scheduling, registration, patient pre-admission and admission, reception and discharge functions. Must obtain complete and accurate patient demographic information.  Patient Access representatives also must employ proper, compliant patient liability collection techniques before, during & after date of service.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

1. Greeting patients following Conifer Standards of Care, provides world-class customer service, completes full patient registration at date of service, adheres to financial & cash control policies & procedures, thoroughly explains and secures Hospital & patient legal forms (i.e., Advance Directives, Conditions of services, Consent for treatment, Important Message from Medicare, EMTALA, etc.). Scan Protected Health Information, create and file patient information packets/folders for upcoming Hospital services.  May also assist with scheduling diagnostic procedures (enters data in scheduling system, provide customer with appointment instructions, other tasks as needed).
2. Educates patients about patient financial liabilities, employs proper, compliant patient liability collection techniques before, during & after date of service, performs Hospital cash reconciliation & secured payment entry in adherence to financial & cash control policies & procedures.
3. Secures medical necessity checks/verification in accordance to Centers for Medicare & Medicaid services, verifies insurance, benefits, coverage & eligibility, completes assigned registration financial clearance work lists activities, obtains insurance authorizations for scheduled & unscheduled Hospital services, and secures inpatient visit notification to payors.  May also assist with scheduling and coordinating post discharge care for patients.

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Minimum typing skills of 35 wpm
• Demonstrated working knowledge of PC/CRT/printer
• Knowledge of function and relationships within a hospital environment preferred
• Customer service skills and experience 
• Ability to work in a fast paced environment 
• Ability to receive and express detailed information through oral and written communications
• Understanding of Third Party Payor requirements preferred
• Understanding of Compliance standards preferred
• Must be able to perform essential job duties in at least two Patient Access service areas including Emergency Department.
• Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors.
• Builds and maintains collaborative relationships with both internal and external Clients that lead to more effective communication and a higher level of productivity and accuracy. 
• Must be able to appropriately interpret physician orders, medical terminology and insurance cards while maintaining Conifer Standards of Care.

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment.  This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

  EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.

• High School Diploma or GED required.
• 0 - 1 year in a Customer Service role. 
• 0 - 1 year administrative experience in medical facility, health insurance, or related area preferred
• Some college coursework is preferred 

  PHYSICAL DEMANDS 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to sit at computer terminal for extended periods of time.
• Resolves Physician's office and Patient issues. May experience extreme patient volumes and uncooperative Patients. 
• Occasionally lift/carry items weighing up to 25 lbs.
• Frequent prolonged standing, sitting, and walking.
• Occasionally push a wheelchair to assist patients with mobility problems.

WORK ENVIRONMENT 

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Hospital administration
• Can work in patient care locations which include potential exposure to life-threatening patient conditions. 

OTHER

• Must be available to work hours and days as needed based on departmental/system demands.

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions?  Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!