The responsibilities of the individual in this position include but are not limited to the following: a) Follow up on patient accounts when authorization for stay is required, fax numbers to send clinical reviews; b) Follow up on each account during the stay and on discharge for authorization - document in the electronic system; c) Escalate any potential disputes or denial of accounts to Director of Case Management or designee; d) Trends disputed claims by payor and physician; e) assist in obtaining authorization for patient discharged to Skilled Facilities or other post-acute care who require authorization and f) other duties as assigned. Also provides general support for Case Managers with insurance cases, denials, appeals, etc. Provides assistance to Case Management staff , Insurance companies and Home Health Agency representatives in a positive and professional manner. Maintains and demonstrates excellent organizational and communication skills in dealing with physicians, patients, public and members of the hospital staff when an assertive but tactful demeanor is required. Maintains confidential files of correspondence, statistical reports and documents relative to operation and prepares confidential correspondence for the Case Management Team with little or no direction. Coordinates, assists and advises on a variety of meetings, seminars, services and/or programs.
Candidates will be working from Good Samaritan Medical Center.
Qualifications: Position Qualifications
Minimum: High school graduate or equivalent
Preferred: Associates or Bachelorï¿½s Degree; Nursing background
Proficiency in MS Word, Excel and PowerPoint presentation applications; Internet; Medical Terminology and/or Healthcare experience required. Previous experience coordinating operations and management activities required. Acute hospital experience preferred
Paramedic, EMT or Nursing Assistant certification preferred
Demonstrated good problem solving abilities and organizational skills. Demonstrated ability to provide service excellence in daily activities. Solid verbal and written communication skills
Primary Location: Delray Beach, Florida
Facility: Delray Medical Center
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 2005043774
About Delray Medical Center
Tenet Healthcare Corporation (NYSE: THC) is a diversified healthcare services company headquartered in Dallas with 112,000 employees. Through an expansive care network that includes United Surgical Partners International, we operate 65 hospitals and approximately 510 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers and other care sites and clinics. We also operate Conifer Health Solutions, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve.
To improve the patient experience by providing health care providers; patients and their families; and others with information, education, networking opportunities, and related resources focused on best practices.