Specialist-Patient Placement

Job Title

Recommends the most efficient, cost-effective utilization of resources within the continuum of care, prior to the delivery of services. Evaluates, assesses, plans, and facilitates a plan of care. Obtains/Validates insurance prior authorizations and pre-certification for inpatient and/or outpatient healthcare services. Some overtime and call back is required. This position is under the general direction of the leadership of Centralized Patient Access or Baptist Connected Center-Corporate. Performs other duties as assigned

Job Responsibilities

Assesses and evaluates clinical and financial information available and recommends the most appropriate setting for service delivery, including level of care in order to optimize resource consumption and reimbursement.

Precertifies patient care services that require precertification, as identified, in a timely, efficient manner, in order to optimize reimbursement for the patient, as well as health care providers.

Communicates recommendations, clinical information, and fiscal information to appropriate internal and external customers in order to facilitate optimal delivery of services and customer satisfaction.

Participates in the planning, data collection, and analysis phases of performance improvement activities in order to maximize the patient placement/precertification process.

Completes assigned goals

Experience

Minimum Required 5 years of business/clinical experience in a healthcare

Preferred/Desired 8 years of business/clinical experience in a healthcare

Education

Minimum Required Associates degree or equivalent years of work experience.

Preferred/Desired Bachelor's degree or equivalent years of work experience

Special Skills

Minimum Required Excellent communication skills. Advanced computer literacy skills

Baptist Memorial Healthcare Corporation