Lifepoint Health®
Overview
Georgetown Community Hospital is an acute care hospital with 75 beds offering a broad range of inpatient, outpatient, intensive care, surgical, emergency and diagnostic services. From our bariatrics to women's services to radiology, we have a wide range of services that serve our community.
Who We Are Georgetown Community Hospital — People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do.
Where We Are Georgetown is a small town bursting with charm in the midst of Kentucky Horse Country and is the true birthplace of bourbon. We are Kentucky\'s fastest growing city with diverse adventures including local shops, restaurants, craft breweries and a bourbon distillery.
Why Choose Us
Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
Competitive Paid Time Off
Employee Assistance Program - mental, physical, and financial wellness assistance
Tuition Reimbursement/Assistance for qualified applicants
Options for accident, critical illness, long-term, short-term, and hospital indemnity insurance
Professional development opportunities
Free Parking
And much more
Position Summary Under the general direction of the department director, the Physician Services Surgery Authorization Specialist will primarily be responsible for authorizing medical procedures for prospective patients by coordinating all aspects of the scheduling cycle. This will initially include order intake via phone queue and fax as well as insurance benefit verification. The position also requires the ability to handle clinical assessment and insurance authorizations that are necessary preconditions for qualifying patients both medically and financially for final appointment confirmation. A basic understanding of insurance material such as claims, denial resolution, and appeals is needed as required. This role reflects a "help desk" approach to authorizing by actively responding to the general needs of the ordering physician and their patients.
Minimum Education
High School Diploma or equivalent, Preferred
Associate\'s degree, Preferred
Minimum Work Experience
3-4 years experience in a medical environment (hospital ancillary department, doctor\'s office, x-ray lab), preferably with additional exposure to a related field such as registration, claims and patient financial services, or other ancillary department experience.
A broad employment history in these settings will be most helpful.
Required Skills
Must possess a working knowledge of commonly used healthcare concepts, practices, and procedures with particular emphasis on Outpatient Services.
Requires a demonstrated ability to evaluate a patient\'s medical history via chart notes or other clinical source and accurately apply it to commercial insurance utilization criteria.
Must be able to stand, walk, and conduct frequent face-to-face encounters with patients and medical staff throughout the hospital for a significant portion of the workday when required.
Any special knowledge, skills, certification, or training will be particularly valuable (e.g. bilingual (Spanish/English), coding certificate, prior clinical background, prior managed care employment, etc.).
1 year in customer service or similar role. Familiar with call center environment preferred
Essential Functions
Requires excellence in customer service and telephone etiquette.
Must be able to participate in receiving phone calls via a department telephone queue.
Uses clinical knowledge to receive orders for review and clarification when needed, including medical necessity checking for all Medicare patients.
Must be able to integrate a variety of clinical data, assess, and conduct medical necessity reviews with appointed utilization review departments. This will include exchanging clinical information with clinic staff and physicians and negotiating the best possible outcome or alternative modality.
Must show a strong attention to detail including an ability to transfer patient data in a reliable and consistent manner within regulatory guidelines.
Must show an ability to work in a culturally diverse work environment and display a sensitive approach toward those with learning disabilities or other communication challenges.
Basic to intermediate math calculation, writing, and spelling skills are essential. Requires intermediate computer knowledge and the ability to utilize software applications such as Microsoft Office and related programs.
EEOC Statement Georgetown Community Hospital is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans\' status or any other basis protected by applicable federal, state or local law.
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Who We Are Georgetown Community Hospital — People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do.
Where We Are Georgetown is a small town bursting with charm in the midst of Kentucky Horse Country and is the true birthplace of bourbon. We are Kentucky\'s fastest growing city with diverse adventures including local shops, restaurants, craft breweries and a bourbon distillery.
Why Choose Us
Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
Competitive Paid Time Off
Employee Assistance Program - mental, physical, and financial wellness assistance
Tuition Reimbursement/Assistance for qualified applicants
Options for accident, critical illness, long-term, short-term, and hospital indemnity insurance
Professional development opportunities
Free Parking
And much more
Position Summary Under the general direction of the department director, the Physician Services Surgery Authorization Specialist will primarily be responsible for authorizing medical procedures for prospective patients by coordinating all aspects of the scheduling cycle. This will initially include order intake via phone queue and fax as well as insurance benefit verification. The position also requires the ability to handle clinical assessment and insurance authorizations that are necessary preconditions for qualifying patients both medically and financially for final appointment confirmation. A basic understanding of insurance material such as claims, denial resolution, and appeals is needed as required. This role reflects a "help desk" approach to authorizing by actively responding to the general needs of the ordering physician and their patients.
Minimum Education
High School Diploma or equivalent, Preferred
Associate\'s degree, Preferred
Minimum Work Experience
3-4 years experience in a medical environment (hospital ancillary department, doctor\'s office, x-ray lab), preferably with additional exposure to a related field such as registration, claims and patient financial services, or other ancillary department experience.
A broad employment history in these settings will be most helpful.
Required Skills
Must possess a working knowledge of commonly used healthcare concepts, practices, and procedures with particular emphasis on Outpatient Services.
Requires a demonstrated ability to evaluate a patient\'s medical history via chart notes or other clinical source and accurately apply it to commercial insurance utilization criteria.
Must be able to stand, walk, and conduct frequent face-to-face encounters with patients and medical staff throughout the hospital for a significant portion of the workday when required.
Any special knowledge, skills, certification, or training will be particularly valuable (e.g. bilingual (Spanish/English), coding certificate, prior clinical background, prior managed care employment, etc.).
1 year in customer service or similar role. Familiar with call center environment preferred
Essential Functions
Requires excellence in customer service and telephone etiquette.
Must be able to participate in receiving phone calls via a department telephone queue.
Uses clinical knowledge to receive orders for review and clarification when needed, including medical necessity checking for all Medicare patients.
Must be able to integrate a variety of clinical data, assess, and conduct medical necessity reviews with appointed utilization review departments. This will include exchanging clinical information with clinic staff and physicians and negotiating the best possible outcome or alternative modality.
Must show a strong attention to detail including an ability to transfer patient data in a reliable and consistent manner within regulatory guidelines.
Must show an ability to work in a culturally diverse work environment and display a sensitive approach toward those with learning disabilities or other communication challenges.
Basic to intermediate math calculation, writing, and spelling skills are essential. Requires intermediate computer knowledge and the ability to utilize software applications such as Microsoft Office and related programs.
EEOC Statement Georgetown Community Hospital is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans\' status or any other basis protected by applicable federal, state or local law.
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