Overnight Prior Authorization Representative Express Scripts Jobs in Bessemer, AL

JOB SUMMARY 

Work Location: Shelby Medical Center

Shift Information: Monday-Friday, Day Shift, No Weekends

Responsible for accurately scheduling complex diagnostic and/or surgical procedures. Conducts physician office/patient interviews, and explains hospital procedure guidelines and policies.  Coordinates with clinical departments on schedule modifications. 

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Responsible for obtaining complete and accurate clinical, demographic and financial information during the scheduling process.   Enters data in scheduling system or other applications. Provides the customer with prep and other appointment instructions.  Largely responsible for scheduling complex procedures.
• Follows guidelines for special requests/Stat/schedule modification procedures and coordinates communications with clinical areas to accommodate the customers' requests.  
• Answers telephone calls according to designated scripting for the scheduling process.  Maintains positive customer service at all times, referring unresolved issues to appropriate supervisor.
• Notifies customer of physician order, pre-authorization and other financial clearance requirements.
• Performs functions of other PASU functions or registration when requested.

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 software/system/equipment.
• Knowledge of function and relationships within a hospital environment preferred
• Advance Customer service skills and experience 
• Ability to work in a Call center environment 
• Ability to receive and express detailed information through oral and written communications
• Course in Medical Terminology required
• Advanced understanding in surgery procedure scheduling preferred
• High achievement in productivity.
• 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. 
• Identifies opportunities to improve patient relations and shorten the time it takes to handle scheduling processes.
• This position requires high-level problem solving and analytical skills, technical accuracy, excellent  communication skills and the highest ethical standards.

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 required to perform the job.

• High School Diploma or equivalent 
• 2-5 year administrative experience in medical facility, health insurance, or related area. 
• 3+ years in Patient Access/Scheduling 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
• Occasionally lift/carry items weighing up to 25 lbs.
• Frequent prolonged standing, sitting, and walking

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.
• Resolves Physician's office and Patient issues.  May experience extreme patient volumes and uncooperative Patients. 

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!