Center City, Philadelphia, PA
JOB SUMMARY: This position supports the lead position as well as the below accountabilities. This position must have superior knowledge of insurance industry and its constant changes as it relates to rehab in order to properly verify complex insurance benefits of patient population. Excellent communication skills and the ability to juggle multiple tasks and requests while exercising superior customer service skills.
- Is the back up to the Coordinator position with all relevant knowledge to perform necessary tasks for admissions related to insurance clearance, authorizations and recertifications.
- Communicates financial information to patients, families, Clinical liaisons.
- Prepares necessary documentation for admissions including face sheet, copies of referral information (clinical documentation) armband, consents, etc.
- Communicates with clinical liaisons on a regular basis to maintain list of potential admissions and verify patient arrivals.
- Enters referral (pre-admissions) information in the CPSI computer system.
Reconciles Excel census with SMS reports. Retrieves and reconciles reports and e-mail notifications
from inpatient units.
- Obtains signed consent from patients or family members.
- Maintains logs of patients who were transferred to other institutions. Maintains logs of expected admissions and their potential attending physicians.
- Reviews morning census and confers with inpatient coordinator regarding patient admissions, discharges and transfers. Makes necessary changes in room assignments to accommodate admissions, transfers and discharges.
- Interfaces with internal (clinical liasons, case managers, finance personnel) and external (insurance representatives, referring provider sources) agencies and persons to accept referrals, verify insurance and confirm admissions.
- Uses the EVS and Medicare verification systems to verify eligibility for admissions.
- Is professional and polite in all encounters with Magee staff, patients and outside insurance / payor representatives. Answers telephone in a timely and professional manner.
- Works well without direct supervision. Asks appropriate questions.
- Makes good job-related decisions that are within the scope of the job description and positions’ authority.
- Shows willingness to assist others when his / her own tasks are completed. Is a team worker who will initiate tasks and anticipate needs.
- Performs other duties as assigned.
Education: Associates Degree preferred or 3-5 years’ experience in admissions/discharges with responsibility for coordination of scheduling and bed placement.
- Demonstrated knowledge of medical terminology. Strong working knowledge of insurance plans and prior experience with insurance verification / pre-certification.
- 2-3 years’ experience in an inpatient hospital admissions procedures, knowledge of acute rehabilitation scenarios is preferred.
- Knowledge of insurance plans, managed care, inpatient admissions procedures.
- Demonstrated proficiency with Microsoft Office, On-line Eligibility Systems and mainframe ADT systems.
- Demonstrated skills in organization and prioritization.
- Must be capable of working in a fast-paced environment.
- Strong communication skills for interacting with patients, administrative staff, clinicians and outside agencies.
- Typing ability to rapidly enter demographic and insurance data into a PC.
- Ability to organize and prioritize tasks and interact with clinicians, patients and administrative staff at all levels.
- Prior experience working in a customer service role or positions where interpersonal and diplomatic skills are utilized.
Conditions of Employment
Since this position will require the selected candidate to engage in regular contact with children in the form of care, guidance, supervision or training, you will be required to meet the requirements of the Child Protective Services Act, including the Pennsylvania State Police criminal background check, the Pennsylvania Department of Welfare child abuse criminal background clearance, and an FBI finger print based federal criminal records check. The selected candidate will not be allowed to commence working until all three (3) are completed satisfactorily.
Jefferson Health delivers state of the art healthcare services to patients throughout the Delaware Valley and southern New Jersey. Jefferson (Philadelphia University + Thomas Jefferson University) provides more than 8,400 students from nearly 40 states and 40 countries with 21st century professional education. Combined, we have over 30,000 employees.
Jefferson Health, with 14 hospitals (seven are Magnet designated by the ANCC for nursing excellence) and 40+ outpatient and urgent care locations, offers a broad range of primary and complex, highly specialized care that touches the lives of more than four million patients annually. U.S. News & World Report has ranked Thomas Jefferson University Hospital among the nation’s best in eight specialties. Jefferson Health also includes the NCI designated Sidney Kimmel Cancer Center; it is one of only 70 such centers in the nation.
Thomas Jefferson University has ten colleges and three schools that offer more than 160 undergraduate and graduate programs. Our University is dedicated to inter-professional and transdisciplinary approaches to learning that offer a vibrant and expandable platform for professional education. Through this unique model, we are preparing our students for current and yet to be imagined careers.
As an employer, Jefferson maintains a commitment to provide equal access to employment. Jefferson values diversity and encourages applications from women, members of minority groups, LGBTQ individuals, disabled individuals, and veterans.
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