Clinical Coordinator

JOB SUMMARY:

To verify and monitor patient insurance benefits, authorization, and enter information required into the computer.

ESSENTIAL RESPONSIBILITIES:

Verifies and obtains all authorizations and necessary pre-certifications from insurance companies. Informs Supervisor about patients who are underinsured or without insurance Perform verification of Medicare coverage and limits on all Medicare accounts of inpatients. Communicates benefit information with the attending physician. Determines patient review dates according to established diagnostic criteria. Maintains accurate patient insurance information. Keeps informed of all new registration procedures. Performs quality reviews on all financial files on a daily basis. Participates in Discharge Planning Meeting Daily. Maintains established departmental policies and procedures, objectives, performance improvement program, safety environmental and infection control standards. Notifies supervisor concerning admissions that do not meet the hospital financial policy criteria. Analyzes insurance, governmental, and accrediting agency standards to determine criteria concerning admissions, treatment, and length of stay of patients. Participates in educational programs and in-service meetings as required. Prepares statistical reports. Performs all related duties as requested or assigned. Keeps informed on the "Baker Act" and Mental Health related laws. Strives to communicate effectively and courteously with all groups as delineated by interactions. Immediately reports to the supervisor any occurrences or situations that are out of the norm. Should participate in Quality Improvement activities as oriented by Supervisor.

SKILLS AND ABILITIES:

Speak clearly and listen carefully. Use personal judgement and specialized knowledge to give information to people. Communicate well with the diverse population we serve. Ability to multitask. Provide excellent customer service. Provide solutions to problems. Use eyes, hands, and fingers accurately while operating a switchboard or computer.

PHYSICAL DEMANDS:

Sedentary Work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, or pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time.

ENVIRONMENTAL CONDITIONS:

Inside: Protection from weather conditions but not necessarily from temperature changes.

REASONING DEVELOPMENT:

Be able to apply principles of rational systems to solve practical problems and deal with a variety of concrete variables. Interpret and direct a variety of instructions furnished in written, oral, diagrammatic or schedule form.

MATHEMATICAL DEVELOPMENT:

Add, subtract, multiply, and divide all units of measure. Perform the four operations with common and decimal fractions. Compute ratio, rate, and percent. Draw and interpret bar graphs. Perform arithmetic operations involving all American monetary units.

LANGUAGE DEVELOPMENT:

Reading: Read and understand instructions, Patients' Rights, etc. Writing: Write reports with proper format, punctuation, spelling, and grammar, using all parts of speech. Speaking: Speak with poise, voice control, and confidence, using correct English and a well-modulated voice.

RELATIONSHIPS TO DATA, PEOPLE AND THINGS:

Data: Compiling: Gathering, collating, or classifying information about data, people or things. Reporting and/or carrying out a prescribed action in relation to information are frequently involved. People: Speaking-Signaling: Talking with and/or signaling people to convey or exchange information. Includes giving assignments and or directions to helpers or assistants. Things: Operating-Controlling: Starting, stopping, controlling and adjusting the progress of machines or equipment, setting up and adjusting the machine or materials as the work progresses. Using body members, and/or special devices to work, move or carry objects or material.

QUALIFICATION:

An Associate Degree minimum. Specific Preparation: Specific Preparation includes an occupationally significant combination of, or essential experience in hospital admission or customer relation. On the job training or equivalent training in the admitting process. Be familiar with medical terminology. Be proficient in using a typewriter and computer for data processing. Minimum 1 year experience in hospital or mental health setting. Bilingual (English/Spanish) desired. #J-18808-Ljbffr Westchester General Hospital