This job listing has expired and the position may no longer be open for hire.

Administrative Assistant at BEACON HEALTH SYSTEM in Granger, Indiana

Posted in General Business 30+ days ago.

Type: Full-Time





Job Description:

  • Reports to the Director of Managed Care. Assists in the pre-certification and credentialing processes. Represents Managed Care Services in a highly positive manner and provides visitors and callers with reasonable assistance with the utmost regard for customer service and guest relations.
MISSION, VALUES and SERVICE GOALS


  • MISSION: We deliver outstanding care, inspire health, and connect with heart.


  • VALUES: Trust. Respect. Integrity. Compassion.


  • SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Assists in the pre-certification and credentialing processes by:

    • Taking utilization review (UR) pre-certification phone calls, including requesting and obtaining necessary information for pre-certification.

    • Assigning a pre-certification number, completing the pre-cert form and sending it to the provider.

    • Creating and distributing pre-certification letters.

    • Answering customer service calls from providers, patients and payors.

    • Maintaining the database in UR system.

    • Contacting providers and members for additional information necessary to complete pre-certification.

    • Assisting with researching and resolving claims issues and disputes involving paid and unpaid claims.

    • Serving as a contact person for payor claims personnel.

    • Routinely interacting with Community Health Alliance (CHA) Claims and Provider Relations staff and other payors.


  • Contributes to the overall effectiveness of Managed Care Services by:

    • Developing and maintaining positive working relationships with CHA providers.

    • Educating the provider community, both over the telephone and on-site, regarding utilization review and the pre-certification process.

    • Providing payors with weekly file of authorizations completed.

    • Providing back-up f or the claims function by processing CHA and workers compensation claims as requested.


  • Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department by:
      • Completing other job-related assignments and special projects as directed.
    ORGANIZATIONAL RESPONSIBILITIES
    • Associate complies with the following organizational requirements:


      • Attends and participates in department meetings and is accountable for all information shared.

      • Completes mandatory education, annual competencies and department specific education within established timeframes.

      • Completes annual employee health requirements within established timeframes.

      • Maintains license/certification, registration in good standing throughout fiscal year.

      • Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.

      • Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.

      • Adheres to regulatory agency requirements, survey process and compliance.

      • Complies with established organization and department policies.

      • Available to work overtime in addition to working additional or other shifts and schedules when required.



    • Education and Experience
      • The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of an Associate's degree with courses in business, health administration, nursing or a related field. A minimum of two to three years of successful experience in the health care industry, health care customer service or an office position where customer service skills were utilized. Medical terminology knowledge preferred.

      Knowledge & Skills

      • Requires working knowledge of medical terminology and ICD-9 and CPT-4 reference material.

      • Requires the ability to operate office equipment (copier, fax machine, calculator, etc.) specific to the department's needs.

      • Demonstrates well developed computer skills (i.e., data entry, word processing, spreadsheets and database applications).

      • Demonstrates strong verbal and written communication skills in order to communicate effectively with various contacts.

      • Demonstrates effective interpersonal skills necessary to interact in a professional and customer service-oriented manner.


      Working Conditions
      • Works in an office environment.

      Physical Demands
      • Requires the physical ability and stamina to perform the essential functions of the position.






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