Inspire health. Serve with compassion. Be the difference. Job Summary Support the department by performing as a liaison for payer communication, assisting with patient's transitions of care, and delivery of required regulatory documents. Effective communication skills to engage collaboratively with case management staff, patients/family members, and all other healthcare professionals.
Essential Functions
All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Support patient throughput by performing transition of care activities (e.g., referrals and placement for post-acute services, providing notification letters to patient/family regarding regulatory rights, maintaining consistent communication with Post-Acute Providers and Care Management staff). Manages all payer communications, including faxes and voice mails from payors for authorizations and denials. Communicates with payors regarding discharge dates and dispositions. Manages the authorization fields in the EMR and work accounts timely to ensure that billing is processed efficiently. Interacts with patients and facilitate communication between care team members. Documents communications in the EMR with payors, delivery of forms, and interactions with patients and care team members, as appropriate. Performs other duties as assigned.
Supervisory/Management Responsibility
Minimum Requirements
Education - High School diploma, GED or higher. Experience - One (1) year of unit secretary, physician practice, health insurance or related healthcare facility experience.
In Lieu Of
Required Certifications, Registrations, Licenses
Knowledge, Skills and Abilities
Strong organizational, time management, problem solving, and critical thinking skills required Medical Terminology course/knowledge preferred
Work Shift Day (United States of America)
Location Greenville Memorial Med Campus
Facility 7001 Corporate
Department 70017535 Utilization Management
Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
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