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Precertification Specialist / Scheduler (Glenwood Springs Office)

Company: Aspen Valley Hospital
Location: De Beque
Posted on: October 7, 2021

Job Description:

Company Overview:

Embrace the adventure of a career at Aspen Valley Hospital. Aspen Valley Hospital is a twenty-five-bed community hospital that represents the best of two worlds - the warmth and friendliness of a small town and the technical expertise of a major medical center. Our award-winning hospital, nestled in the heart of Aspen, CO, includes a team of more than 500 people dedicated to making a difference for our patients, families, and community. Nationally we are recognized for providing some of the most exceptional patient care of any hospital across the country.

This Position Offers:

Highly competitive pay, 40 hours per week, comprehensive benefits package (including generous PTO, health insurance within your first 30 days, retirement), being part of a very cohesive & supportive team, professional work environment, convenient west Glenwood Springs office location, paid training, and much more.

Job Overview:

To assist in scheduling patient encounters for all clinical service departments using Electronic Medical Record (EMR) system for Scheduling and B/AR module. To act as liaison between Hospital departments to effectively coordinate scheduling of tests and procedures. Responsible for pre-authorization function to assure accurate and timely payor information and fiscal responsibility.

Primary Scope of Responsibilities:

  • Accurately schedules appointments, choosing appropriate appointment types, and correct data entry. Professional & responsive communication with physicians, patients, and departments.
  • Mammo - interviews & schedules patients using: symptoms/screening, Insurance/Komen or other Grants, implants, & requests for previous films. Assist Breast Liaison with follow-up. Keeps current on all grant criteria & requirements.
  • Produces day end reports & distributes. Includes reviewing scanned orders, correct procedure vs. actual order, and ABN if needed has been processed & distributed accordingly.
  • Works with other PFS staff to ensure fiscal management of appointments. Stays current on Medicare & insurance requirements, ensuring ABN's & insurance waivers & pre-certs are completed & communicated to patient & scanned.
  • Understands and complies with all Hospital, patient confidentiality, ABN's and insurance waivers. Participates in trainings & staff meetings. Reads daily summary reports & emails to be aware of changes.
  • Utilizes computerized scheduling and B/AR modules to maximize benefit for AVH and customers. Adapts software to meet needs.
  • Provides assistance to other departments as needed.
  • Fiscal responsibility including reviewing and completing ABN's, Insurance authorizations/waivers, and ensuring completed precertification as needed.
  • Schedules and pre-certifies all Physical Therapy patients-at all AVH locations. Reviews and monitors CAP requirements and ABN's for Medicare patients. Pre-certify and/or check for MCR ABN on all patients with scheduled lab tests-at all AVH locations. As above does all pre-certification, insurance authorizations and waivers, required ABN's and CAPS.
  • Records pertinent documentation in accordance with regulatory requirements, professional standards and hospital policy.
  • Adheres to federal, state and hospital rules and regulations concerning HIPAA privacy and security.
  • Follows Hospital compliance plan and policies, including the Code of Conduct.
  • Participates in required training for compliance related activities (HIPAA, Compliance, Patient Safety, TJC, etc.)

Minimum Qualifications & Requirements:

  • Strong interpersonal skills required
  • Ability to manage a high-paced work environment required
  • Basic computer proficiency required (Windows, Microsoft Outlook & Excel, typing)
  • Spanish preferred
  • 2-3 years of experience in related healthcare field preferred
  • Ability to concentrate and show attention to detail

Benefits & Compensation:

Our hire-in rates of pay are based on years of relevant experience. Listed below are our hire-in rates for the position, which includes: minimum pay (no relevant experience) and mid-point (12 or more years).

Minimum = $22.00/hr

Mid-Point = $27.43/hr

Our comprehensive benefits package includes generous paid time off, health insurance within your first 30 days, retirement, and much more can be viewed here.

Keywords: Aspen Valley Hospital, Snowmass , Precertification Specialist / Scheduler (Glenwood Springs Office), Other , De Beque, Colorado

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