Patient Access - Infu/Chemo Spc ALG in Allegan, Michigan at Beacon Health System

This position performs various tasks directly related to collecting and analyzing of data for the process of registering, obtaining authorization and pre-notification of services on behalf of the physicians and clinics within Allegan General Hospital. This position also performs specific high level clerical duties within an Infusion and Chemotherapy Clinic. This position is critical in working with the all departments within and outside of the hospital to collect and report correct patient demographics and insurance information and authorizations and daily operations of a Provider Based Clinic.

Responsibilities:
Registers outpatients for appropriate services. Collecting accurate patient demographic, current insurance information and obtaining on behalf of the physician and Allegan General Hospitals clinic(s) authorization for scheduled services specifically related to Chemotherapy and Infusion services as well as Outpatient Prescriptions for the Infusion and Chemotherapy Clinic patients. Accurately recording and documenting prior authorized or pre-certification numbers for payment and follow up. Accurate
and appropriate recording and use of Mosiac Electronic Medical Record. Obtains authorizations on behalf of Physician Practices when required, and maintains training for Authorizations.

Promotes and maintains excellent communication with all ordering physician offices, hospital departments, insurance companies, and Drug Representatives for obtaining orders, prior authorization, pre-certification and discounts in copayments for services of scheduled patient services.

Obtains all necessary signatures and/or legal consent for treatment and/or admission. Give Medicare, Observation, Medicare Important Message, Privacy notices and Patient Right information letters when appropriate.

Determines co-pay and payment amounts for self-pay patients. Collects co-pays and self-pay amounts, makes receipt and records and reports all collections. Works with Drug Representatives and other agencies on discounts for affected patients services and co-pay amounts.

Audits work for accuracy. Performs follow up functions as required and /or needed.

Accurately identifies the hospital when answering department phones. Accurately answer, page, beep, transfer calls and assist with voice mail processing. Accurately and timely relay all messages to appropriate parties and/or areas.

Seeks out work that needs to be done and reports free time to the manager.

Maintains positive attitude, speech and appearance. Comply with all department policies.

Accurately and timely perform duties as Department Manager assigns; working with Quality Work Groups.

Maintains personal notebook of department policies, insurance information and changes in those policies and procedures.

Education:

• High school diploma, or GED equivalent, required.

Work Experience:

• Minimum five years’ experience working with or with in an Infusion and Chemotherapy Clinic Setting required.
• Experience in chemotherapy and infusion pre-certification and authorization for services required.
• Experience in chemotherapy and infusion outpatient prescription authorization required.
• Experience and knowledge in Infusion and Chemotherapy office procedures required.
• Knowledge of Mosiac Electronic Medical Record required.