The individual in this position works under direction of Social Worker or Case Manager RN. The individualï¿½s responsibilities include but not limited to the following actions: Follow up on patient accounts for when authorization for stay is required Fax numbers to Send clinical reviews Follow up on each account during the stay and on discharge for authorization - document in the electronic system Escalate any potential disputes or denial of accounts to director of Case Management or designee Trends disputed claims by at least payor and physician (e assist in obtaining authorization for patient discharged to Skilled Facilities or other post acute care that require authorization) Trend by payor and service any authorization not obtained by end of day Trend and Track on denial prevention
Required: High School Graduate or equivalent Preferred: Associates or Bachelorï¿½s degree
Required: Two (2) years of experience in clerical or healthcare field. Preferred: Acute hospital experience.
Preferred: Paramedic, EMT or Certified Nursing Assistant
Primary Location: Hilton Head, South Carolina
Facility: Hilton Head Hospital
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 1905041128
About Hilton Head Hospital
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.