Administrative Coord (BHS) at Beacon Health System – Granger, Indiana

Reports to the Manager of Utilization Management. Under supervision, performs a variety of administrative functions, coordinates, supports and has shared responsibility for key components of the UM function relating to the revenue cycle for the Hospital.

MISSION, VALUES and SERVICE GOALS

• MISSION: We deliver outstanding care, inspire health, and connect with heart.
• VALUES: Trust. Respect. Integrity. Compassion.
• SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Assists the Manager with coordination of the daily general operational activities of the department by:

• Coordinating work assignments in the department by dividing assignments, processing fax communications and messages.
• Maintaining fluid listing of payers and their requirements for timely reviews and determinations.
• Coordinating efforts with end user departments such as Patient Access and Verification of Benefits to obtain authorization from payers for all patient stays.
• Following up with payers on all discharged patient accounts to ensure proper and final authorization has been received and documented.
• Coordinating written and faxed communication regarding the reimbursement cycle by entering documentation in Cortex and scanning authorizations and denials into Cerner Power chart.

Supports the UM appeal process by:

• Coordinating the physician-to-physician clinical reviews with insurance companies, Medical Directors and Attending Physicians. Follows standard process for scheduling peer to peer.
• Notifying Appeals Coordinator or Utilization Management RN of the need for or the intent to file an appeal.
• Follows up on discharge patient without authorization.

Provides administrative support to the Manager / department by:

• Coordinating minor projects by researching, pulling together information, and updating files.
• Coordinating communication with UM RNs by answering phones/voicemail, taking and relaying messages accurately. Monitors fax folder and ensures faxes are routed and filed accurately in Cortex and EMR.
• Establishing and maintaining electronic record-keeping and filing systems.
• Opening, sorting and distributing mail, and responding to routine requests for information.
• Operating a variety of standard office equipment (i.e. computer, printer or multi-function device) and contacting vendors for maintenance/repairs as needed.
• Contacting various staff to obtain information or relay information regarding meetings or to resolve payroll, purchasing and computer related problems.
• Coordinating efforts with Manager to monitor and report on all Key Performance Indicators.

Contributes to the overall effectiveness and efficiency of the Utilization Management Department by:

• Assisting in staff scheduling and providing orientation regarding general office practices to new staff.
• Assists in securing access for all applications for new employees.
• Looking for opportunities to improve departmental operations and sharing feedback on process improvements.
• Completing annual mandatory in-services (infection control, safety, etc.).
• Completing other job-related assignments and special projects as directed.
• Appropriately maintaining the integrity and confidentiality of the patient record.
• Maintaining current knowledge of location of relevant departments of the hospital.
• Establishing, maintaining and updating contact information (phone/fax) of providers.
• Ensures office is well organized both physically and virtually.

ORGANIZATIONAL RESPONSIBILITIES

Associate complies with the following organizational requirements:

• Attends and participates in department meetings and is accountable for all information shared.
• Completes mandatory education, annual competencies and department specific education within established timeframes.
• Completes annual employee health requirements within established timeframes.
• Maintains license/certification, registration in good standing throughout fiscal year.
• Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
• Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
• Adheres to regulatory agency requirements, survey process and compliance.
• Complies with established organization and department policies.
• Available to work overtime in addition to working additional or other shifts and schedules when required.

Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:

• Leverage innovation everywhere.
• Cultivate human talent.
• Embrace performance improvement.
• Build greatness through accountability.
• Use information to improve and advance.
• Communicate clearly and continuously.

Education and Experience

• The knowledge, skills and abilities as indicated below are normally acquired through successful completion of Associates degree (or equivalent). A minimum of three to five years of progressively responsible experience (where knowledge of office procedures and organization skills were obtained) in a related environment is required. Previous experience in a leadership role is desired.

Knowledge & Skills

• Requires fundamental knowledge of the revenue cycle process, which includes such things as patient access, verification of benefits, utilization review, and knowledge of rules and regulations pertaining to hospital reimbursement by different payers.
• Demonstrates a working knowledge of the Hospital's computer systems (e.g. Star, Cerner, XSOLIS, and Active Staffer) and proficiency in basic computer skills (i.e. data entry, word processing, spreadsheets, utilizing the internet, etc.).
• Demonstrates the interpersonal and communication skills (both verbal and written) necessary to develop and maintain productive working relationships and to interact effectively with internal and external contacts. Also requires well-developed telephone usage skills.
• Requires the interpersonal skills necessary to maintain effective working relationships and interact effectively with staff, physicians, review agencies, and insurance companies.
• Demonstrates the ability to be self-motivated and analytical with organizational skills to independently work on and complete assignments in time allocated. Also demonstrates the ability to respond quickly and appropriate to demands of the position.
• Demonstrates the ability to maintain professional composure under pressure and to handle stress effectively.
• Demonstrates the ability to maintain professional composure under pressure and to handle stress effectively.
• Demonstrates and maintains ethical conduct and the ability to exercise discretion.

Working Conditions

• Works an office environment and patient care areas.
• May have contact with patients and family members who may be under considerable stress.
• May be exposed to bio-hazards.

Physical Demands

• Requires the physical ability and stamina, visual acuity, and manual dexterity to perform the essential functions of the position.