Description:

The individual in this position works under direction of Social Worker or Case Manager RN.
The individual s responsibilities include but not limited to the following actions:
Follow up on patient accounts for when authorization for stay is required
Fax numbers to Send clinical reviews
Follow up on each account during the stay and on discharge for authorization - document in the electronic system
Escalate any potential disputes or denial of accounts to director of Case Management or designee
Trends disputed claims by at least payor and physician (e assist in obtaining authorization for patient discharged to Skilled Facilities or other post acute care that require authorization)
Trend by payor and service any authorization not obtained by end of day
Trend and Track on denial prevention

Qualifications:

Education

Required: High School Graduate or equivalent
Preferred: Associates or Bachelor s degree

Experience

Required: Two (2) years of experience in clerical or healthcare field.
Preferred: Acute hospital experience.

Certifications

Preferred: Paramedic, EMT or Certified Nursing Assistant

Employment practices will not be influenced or affected by an applicant’s or employee’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.

Tenet participates in the E-Verify program. Follow the link below for additional information.

E-Verify: http://www.uscis.gov/e-verify