Description

Department:

02409 WFBMG University Group Practice: WFBMC Main - Surgery: Plastic and Reconstruction

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

Monday - Friday

Pay Range
$20.40 - $30.60

EDUCATION/EXPERIENCE: High school diploma or GED equivalent with two years of clerical experience with an understanding of medical insurance and preauthorization required. Medical office or insurance experience required. Knowledge of medical terminology, managed care experience, and knowledge of ICD-CM9 and CPT coding preferred.

LICENSURE, CERTIFICATION, and/or REGISTRATION: N/A

ESSENTIAL FUNCTIONS:

1. Collects and organizes patient demographic information required to preauthorize medical services.

2. Obtains authorization and documents specific services authorized, expiration date and other relevant information.

3. Establishes and maintains contacts and cooperative working relationships with payor representatives.

4. Obtains and comprehends new payor contracts to enable informed communication and timely preauthorization.

5. Reviews accounts to determine need for re-certification.

6. Prepares and mails treatment progress notes, plans, goals and guidelines as requested by payors.

7. Provides general information and answers to inquiries concerning preauthorization processes.

8. Acts as a liaison with various agencies to advise patients regarding coverage preauthorization.

9. Interacts directly with patients by telephone or in person to inform of preauthorization requirements and confirm coverage.

10. Interacts with other clinic staff to facilitate accurate, comprehensive and timely preauthorization of services.

11. Maintains patient charts, related files, correspondence, and up-to-date payor contracts.

12. Updates and trains reception staff through in services and memorandum on new contracts and requirements of clinical staff.

13. Prepares statistical reports as requested by management.

14. Performs other duties incidental to the work described herein.

SKILLS/QUALIFICATIONS:

• Ability to perform multiple tasks simultaneously
• Strong computer experience

WORK ENVIRONMENT: Medical office/clinic

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

Under general supervision, utilizes independent judgment and skills to preauthorize physician services, ancillary services, surgical procedures, and other related medical, therapeutic and diagnostic services. Responsible for maintaining accurate and most recent guidelines of third party payors, government payors and managed care companies required to preauthorize medical services successfully.