BJC HealthCare
Overview
Barnes-Jewish Hospital
at Washington University Medical Center is the largest hospital in Missouri and is ranked as one of the nation's top hospitals by U.S. News & World Report. Barnes-Jewish Hospital's staff is composed of full-time academic faculty and community physicians of Washington University School of Medicine, supported by a house staff of residents, interns, fellows and other medical professionals. Recognizing its excellence in nursing care, Barnes-Jewish Hospital was the first adult hospital in Missouri to be certified as a Magnet Hospital by the American Nurses Credentialing Center.
The Department of Ambulatory Services at Barnes-Jewish Hospital consists of the multidisciplinary staff of BJH Ambulatory Services including responsibility for the GI Labs, Minor Procedure Center, Pain Management Center, Diabetes Center, Resident Clinics, Wound/Ostomy Center and other services as assigned. This department assures that all customers receive the highest level of attention and prompt, courteous service.
Role and Responsibilities Role Purpose
This role is critical in the financial clearance process which assists BJC hospitals enterprise wide in securing the appropriate authorization and/or Notice Of Admission (NOA) to prevent rescheduling the patient or risking net revenue loss. This position is required to obtain authorization on behalf of some physicians at Washington U school of medicine and BJC medical group and must maintain positive relationships. It ensures technology is used to support the scripting and validation of authorization and NOA. The role represents BJC with the highest standard of customer service, compassion and performs all duties in a manner consistent with our mission, vision, values, and service standards. It facilitates components of the patient’s entrance into any BJC facility, including insurance validation, benefit verification, pre-certification & financial clearance. It is responsible for ensuring that the most accurate patient data is obtained and populated into the patient record, particularly authorization data and status. This role requires exceptional attention to detail and knowledge of insurance carriers, Medicare guidelines and federal, state & accreditation agencies.
Responsibilities
Requires a high level of attention to detail and accuracy. Key components include validation of patient information, scheduled test/surgery information, and insurance information. Ensures that the authorization detail placed in the patient’s medical record is accurate. Utilize critical thinking skills to research and resolve mismatches in information which could involve orders/scheduling, registration and insurance systems.
Communication is a key aspect with high visibility and interaction with provider offices, insurance companies, and some patient interaction (typically phone calls for rescheduling under the Ancillary Authorization process). Communicate professionally with emphasis on positive and respectful interaction with patients and offices, and provide consistent excellent customer service in a variety of situations.
Promote teamwork and employee engagement. Contribute to opportunities to improve employee engagement and customer satisfaction, engaging others in a respectful and collaborative manner. Seek opportunities for self-development while achieving department objectives and goals.
Part of a multidisciplinary team which provides authorization support for multiple BJC Hospitals. May support Ancillary Authorization (scheduled outpatient services), Surgery Authorization (scheduled surgical procedures), or NOA processes within the BJC Pre-Arrival Team. Initiate contact with provider offices, payers and payer websites, and access systems/tools to secure and validate authorization information. For Ancillary Authorizations, a review of medical records may be required if initiating the authorization request directly with a payer.
BJC has determined this is a safety-sensitive position. Ability to work in a constant state of alertness and in a safe manner is essential.
Minimum Requirements Education
High School Diploma or GED
Experience
2-5 years
Preferred Requirements Education
Associate's Degree
Experience
5-10 years
Licenses & Certifications
CHAA
Benefits and Legal Statement BJC Total Rewards
At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.
Comprehensive medical, dental, vision, life insurance, and legal services available first day of the month after hire date
Disability insurance* paid for by BJC
Annual 4% BJC Automatic Retirement Contribution
401(k) plan with BJC match
Tuition Assistance available on first day
BJC Institute for Learning and Development
Health Care and Dependent Care Flexible Spending Accounts
Paid Time Off benefit combines vacation, sick days, holidays and personal time
Adoption assistance
To learn more, go to our Benefits Summary.
*Not all benefits apply to all jobs
The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer
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at Washington University Medical Center is the largest hospital in Missouri and is ranked as one of the nation's top hospitals by U.S. News & World Report. Barnes-Jewish Hospital's staff is composed of full-time academic faculty and community physicians of Washington University School of Medicine, supported by a house staff of residents, interns, fellows and other medical professionals. Recognizing its excellence in nursing care, Barnes-Jewish Hospital was the first adult hospital in Missouri to be certified as a Magnet Hospital by the American Nurses Credentialing Center.
The Department of Ambulatory Services at Barnes-Jewish Hospital consists of the multidisciplinary staff of BJH Ambulatory Services including responsibility for the GI Labs, Minor Procedure Center, Pain Management Center, Diabetes Center, Resident Clinics, Wound/Ostomy Center and other services as assigned. This department assures that all customers receive the highest level of attention and prompt, courteous service.
Role and Responsibilities Role Purpose
This role is critical in the financial clearance process which assists BJC hospitals enterprise wide in securing the appropriate authorization and/or Notice Of Admission (NOA) to prevent rescheduling the patient or risking net revenue loss. This position is required to obtain authorization on behalf of some physicians at Washington U school of medicine and BJC medical group and must maintain positive relationships. It ensures technology is used to support the scripting and validation of authorization and NOA. The role represents BJC with the highest standard of customer service, compassion and performs all duties in a manner consistent with our mission, vision, values, and service standards. It facilitates components of the patient’s entrance into any BJC facility, including insurance validation, benefit verification, pre-certification & financial clearance. It is responsible for ensuring that the most accurate patient data is obtained and populated into the patient record, particularly authorization data and status. This role requires exceptional attention to detail and knowledge of insurance carriers, Medicare guidelines and federal, state & accreditation agencies.
Responsibilities
Requires a high level of attention to detail and accuracy. Key components include validation of patient information, scheduled test/surgery information, and insurance information. Ensures that the authorization detail placed in the patient’s medical record is accurate. Utilize critical thinking skills to research and resolve mismatches in information which could involve orders/scheduling, registration and insurance systems.
Communication is a key aspect with high visibility and interaction with provider offices, insurance companies, and some patient interaction (typically phone calls for rescheduling under the Ancillary Authorization process). Communicate professionally with emphasis on positive and respectful interaction with patients and offices, and provide consistent excellent customer service in a variety of situations.
Promote teamwork and employee engagement. Contribute to opportunities to improve employee engagement and customer satisfaction, engaging others in a respectful and collaborative manner. Seek opportunities for self-development while achieving department objectives and goals.
Part of a multidisciplinary team which provides authorization support for multiple BJC Hospitals. May support Ancillary Authorization (scheduled outpatient services), Surgery Authorization (scheduled surgical procedures), or NOA processes within the BJC Pre-Arrival Team. Initiate contact with provider offices, payers and payer websites, and access systems/tools to secure and validate authorization information. For Ancillary Authorizations, a review of medical records may be required if initiating the authorization request directly with a payer.
BJC has determined this is a safety-sensitive position. Ability to work in a constant state of alertness and in a safe manner is essential.
Minimum Requirements Education
High School Diploma or GED
Experience
2-5 years
Preferred Requirements Education
Associate's Degree
Experience
5-10 years
Licenses & Certifications
CHAA
Benefits and Legal Statement BJC Total Rewards
At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.
Comprehensive medical, dental, vision, life insurance, and legal services available first day of the month after hire date
Disability insurance* paid for by BJC
Annual 4% BJC Automatic Retirement Contribution
401(k) plan with BJC match
Tuition Assistance available on first day
BJC Institute for Learning and Development
Health Care and Dependent Care Flexible Spending Accounts
Paid Time Off benefit combines vacation, sick days, holidays and personal time
Adoption assistance
To learn more, go to our Benefits Summary.
*Not all benefits apply to all jobs
The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer
#J-18808-Ljbffr