ChristianaCare is hiring a fulltime Access Coordinator for their neuro office in Newark, DE.
The Access Coordinator is responsible for obtaining benefits and precertification/prior authorizations for imaging, testing and Medications.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Monitor and prioritize incoming patient orders.
Verify patient's insurance benefits.
Obtain authorization via payor website or by phone.
Evaluate portions to be paid and notify the patients of their deductibles and co-insurance amount.
Contact the referring office to obtain any referrals required.
Gather information needed to complete the prior authorization and contact patients as needed to obtain additional information.
Update patients on reason for denial.
Regularly follow up with the status of the authorization.
Initiate appeals for denied authorizations.
Respond to questions regarding the payor's medical policy guidelines.
Confirm accuracy of CPT and ICD-10 diagnosis in the patient's order.
Update Practice of authorization received or denied.
Arrange for medication delivery to the CCHS pharmacy upon authorization approval.
Performs assigned work safely, adhering to established departmental safety rules and practices; reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, patients and visitors.
Performs other related duties as required.
EDUCATION AND EXPERIENCE REQUIREMENTS:
High School Diploma
At least 2 years prior authorization experience preferred
Familiar with medical terminology
Possess professional phone etiquette
Ability to apply good verbal and written communication
KNOWLEDGE, SKILL, AND ABILITY REQUIREMENTS:
Knowledge of procedure authorization and its direct impact on the practice's revenue cycle
Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively.
Basic understanding of human anatomy, specifically musculoskeletal.
Proficient use of CPT and ICD-10 codes.
Knowledge of 3rd party billing practices.
Knowledge of medical terminology.
Excellent computer skills including Excel, Word, and Internet use.
Detail oriented with above average organizational skills.
Plans and prioritizes to meet deadlines.
Excellent customer service skills; communicates clearly and effectively.
Ability to multitask and remain focused while managing a high-volume, time-sensitive workload.
EEO Statement: Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.
UPDATE: ChristianaCare is committed to prioritizing the health and safety of our patients and caregivers. As we continue to meet the needs of our caregivers and our community through the COVID-19 pandemic, our commitment to health and safety requires that we take new steps to ensure a safe environment for medical care for our patients and a workplace that avoids preventable harm for our caregivers. For this reason, vaccination for COVID-19 is required for all caregivers at ChristianaCare and is considered a safety standard that is job-related and consistent with business necessity for all caregivers.
ChristianaCare Health System is headquartered in Wilmington, Delaware and is one of the country's largest health care providers, ranking 21st in the nation for hospital admissions. Christiana Care is proudly a Nurse Magnet recognized institution. Christiana Care Health System is also one of the largest health care providers in the mid-Atlantic region, serving all of Delaware and portions of seven counties bordering the state in Pennsylvania, Maryland and New Jersey. A not-for-profit, non-sectarian health system, Christiana Care includes two hospitals with more than 1,100 patient beds, and is a major teaching hospital with two campuses. Christiana Care is continually recognized for excellence on a regional and national level. Our role in the community is expressed in the Christiana Care Way: "We serve our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value."Christiana Care is a great place to work because we value diversity and recognize it to be a core part of our success. Because of the diversity of our employees, affiliated health professionals and volunteers, we are ...positioned to meet the unique needs of our patients and community. We acknowledge and celebrate the uniqueness and talent of each employee. Because of our talented workforce we are able to provide a quality healthcare experience to our patients and community. We strive to create an inclusive environment in which individual diversity can be leveraged and thrive. Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.