Office Secretary – Case Management
Knox Community Hospital
Full-Time
JOB SUMMARY
Provides support and assistance in the planning, coordination and delivery of case management activities. Contacts third party payers to determine and verify benefits and precertification requirements for admissions and observations. Initiates the precertification process within the timeframe designated by the third party payers. Documents benefits, eligibility, and precertification requirements in the hospital information system. Works in collaboration with the case managers, discharge planner, Business Office and ancillary departments as needed. Works in collaboration with the Hospitalist secretary to obtain needed signatures for death certificates. Adheres to organizational policies and procedures; regulatory/accrediting body requirements; and professional practice standards.
PRIMARY JOB RESPONSIBILITIES
- Initiates the precertification process for all hospital inpatients and observation patients. Verifies patient benefits and effective start dates from their respective health insurance carriers.
- Reviews patients’ accounts and initiates resources to assist the patient in need of financial assistance.
- Documents all pertinent details obtained on the patients’ computer profile.
- Performs status changes within regulatory guidelines.
- Resolve room and board charges due to status changes.
- Accurate entry of patient demographic and third party payer information into the HIS.
- Prepares and distributes meeting minutes, agendas and other correspondence.
- Maintains files for reports, correspondence and other documents.
- Responds to and resolves verbal and written inquiries.
- Develops and maintains departmental systems and processes, including the ordering of supplies.
- Types and processes reports and other documents for the department as needed.
- Retrieves and distributes inter/intradepartmental mail.
- Receives and directs visitors to appropriate personnel.
- Receives and directs telephone and other messages.
- Assists in the development and management of special projects as assigned.
- Maintains indigent patient care petty cash fund.
- Assumes responsibility and accountability for individual knowledge, skills, performance and behavior in accordance with hospital, division, and department standards of care and policies and procedures.
- Utilizes measures to promote and maintain patient, visitor and personnel safety.
- Maintains patient, employee, physician and organization confidentiality; respects the rights, privacy and property of others.
- Supports the mission, values and vision of the organization.
EDUCATION AND WORK EXPERIENCE
- High school diploma or equivalent
- Computer experience preferred
- Work experience with rules and regulations of governmental payers
- Work experience with contractual requirements for third party payers
- Work experience with ICD-9 / ICD-10 and CPT coding
- Work experience with medical terminology
- Minimum of 1 year of recent business/hospital experience; 3 years preferred.
KNOWLEDGE AND SKILLS
- Demonstrated evidence of positive customer service skills.
- Demonstrates effective verbal, written, and telephone communication skills.
- Demonstrates effective computer skills in windows, email, and internet navigation.
- Demonstrated accurate keyboarding/typing skills.
- Demonstrates the ability to prioritize, problem-solve effectively, multi-task, independent decision-making, interpersonal and team work skills.
- Knowledge of rules/regulations of Medicare, Medicaid and third party payers.
- Knowledge of community resources and referral processes.
- Successful completion of mandatory requirements including, but not limited to, departmental competencies.
- Must be able to perform professionally during high stress / high patient volume times.
