Pre-Certification I - Patient Access Pre Clrnc - Miamisburg -
Posted Date 5 days ago (4/9/2024 7:33 AM)
Job ID 2024-48250
Job Category Administrative/Business Support
Job Type Full-Time
Shift First Shift
Department 932493 - PATIENT ACCESS - PRECLRNC
FTE 80 Hours Per Pay Period/FTE 1.0
FTE 80 Hours Per Pay Period/FTE 1.0
Overview
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it’s by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
Campus Overview
Kettering Health Miamisburg
• Serving the residents of Warren, Butler, and Southern Montgomery counties for over 40 years.
• Kettering Health Miamisburg, formerly Sycamore Medical Center, is a full-service hospital located minutes west of the Dayton Mall on Miamisburg-Centerville Road off I-75 in Miamisburg, Ohio.
• The cornerstone services for KH Miamisburg have been Bariatric surgeries and Orthopedic care.
• Expanded services include emergency care, sleep center, mammography, breast MRI, cardiac catheterization lab, wound center and DEXA scanning.
• 142 bed facility
• Awarded with 100 Top Hospital by IBM Watson Health for the 10 th time in 2019.
• In 2020, KH Miamisburg received an “A” from the Leapfrog Group, a national patient safety watchdog, ranking among the safest hospitals in the United States.
• Accredited by the American College of Emergency Physicians as a Level 3 Geriatric Emergency Department.
• KH Miamisburg received several awards from Healthgrades: • Outstanding Patient Experience Award (2017-2019)
• America’s 100 Best Hospitals for Prostate Surgery Award (2020)
• Joint Replacement Excellence Award (2020)
Department Overview
This network-wide position, under the direction of the Pre-Access Manager, Kettering Health, is responsible to facilitate the patient intake process by obtaining and validating precertification’s on scheduled outpatient services, sleep studies, radiation oncology, elective scheduled surgeries and/or additional services as needed . The Representative reviews insurance verification and obtains/ validates precertification information when required at each encounter to ensure accurate and complete billing. This highly visible position must be aware of the importance and impact this position has on KH denial and public relations. The representative provides exceptional customer service to our patients, providers and all other departments and is always expected and required to be exhibited
• Demonstrates through behavior Kettering Health’s mission, vision and services standards as outlined in the organization’s training.
• Maintain competence and use critical thinking skills to promptly resolve consumer inquires within assigned functional area(s).
• Demonstrates successfully to resolve customer inquiries
• Adhere to all established workflows, scripting, and department greetings
• Create delightful customer experience by setting proper expectations and consistently following through with end- users
• D ocument s all interactions and consistently update consumer records in the relevant technology system(s)
• Demonstrates appropriate customer-care skills such as empathy, active listening, courtesy, politeness, helpfulness and other skills as identified to a variety of customers including consumers, clinic staff, physicians, Pre-Access colleagues, and leaders
• Achieves individual key department performance objectives such as quality assurance and productivity.
• Maintain knowledge of Pre-Access and Kettering Health offerings to provide exceptional services
• Handle sensitive matters courteously and with professionalism. When appropriate , escalate with leadership for proper awareness and/or resolution.
• Adhere to department policies and procedures and HIPAA regulations
• Perform other duties as assigned by department leaders
Responsibilities & Requirements
KNOWLEDGE AND SKILLS REQUIRED:
• Ability to articulate the mission of Kettering Health and Pre-Access
• Strong attention to detail and ability to take initiative to resolve inquiries and issues
• Demonstrated personal commitment to promoting and providing excelled customer service
• Demonstrated interpersonal, customer relations, and communication skills; remains patient while interacting with consumers and colleagues
• Exhibits desire to continuously learn, improve service delivery, and work in a team environment
• Ability to listen and document notes simultaneously
• Ability to read, analyze, and interpret verbal and written instruction
• Maintains high energy and positive attitude
• Ability to remain calm under pressure
• Adapts to change and balances multiple priorities in a fast-paced environment
• Demonstrates regular, consistent and punctual attendance
• Effective communicator in English, both orally and in writing
• Computer Proficiency: Microsoft Office Suite programs and basic keyboard typing skills
• Technological aptitude to accomplish additional programs and technologies, including CRM, telephony, electronic health records, and other potential systems
Preferred Qualifications
Q UALIFICATIONS AND EXPERIENCE :
• High school diploma required
• One-year customer service experience required .
• Previous registration/medical /billing office experience preferred.
• Demonstrated competency in working in teams and ability to effectively communicate with all levels.
• Proficient in computer skills and phone skills.
• Ability to function in high paced often stressful environment and/or circumstances while maintaining a respectful, caring and professional manner.
• Must have the ability to perform as a collaborative team member.
• Able to understand and maneuver through clinical documentation in EPIC and payer portal
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