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.
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: 2005028276
About Delray Medical Center
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.