BJC HealthCare is seeking a Prior Authorization Patient Access team member for oncolgy.
This position is remote, but applicants must be located in Missouri or Illinois.
Hours: M-F between 7:30am-5 pm (flex shifts)
The ideal background for this role would be a healthcare professional with experience in oncology or prior authorization with a strong attention to detail.
Overview
Barnes-Jewish Hospital at Washington University Medical Center is the largest hospital in Missouri and is ranked as one of the nation's top hospitals by U.S. News & World Report. Barnes-Jewish Hospital's staff is composed of full-time academic faculty and community physicians of Washington University School of Medicine, supported by a house staff of residents, interns, fellows and other medical professionals. Recognizing its excellence in nursing care, Barnes-Jewish Hospital was the first adult hospital in Missouri to be certified as a Magnet Hospital by the American Nurses Credentialing Center.
The Alvin J. Siteman Cancer Center¿at Barnes-Jewish Hospital and Washington University School of Medicine¿is an international leader in cancer treatment, research, prevention, education and community outreach. It is the only cancer center in Missouri and within a 240-mile radius of St. Louis to hold the prestigious Comprehensive Cancer Center designation from the National Cancer Institute and membership in the National Comprehensive Cancer Network. Parent institutions Barnes-Jewish Hospital and Washington University School of Medicine also are nationally recognized, with U.S. News & World Report consistently ranking the hospital and medical school among the nation's elite.
Preferred Qualifications
Role Purpose
This role is critical in the financial clearance process which assists BJC hospitals enterprise wide in securing the appropriate authorization and/or Notice Of Admission (NOA) in order to pevent rescheduling the patient or risking net revenue loss. This position is required to obtain authorization on behalf of some physicians at Washington U school of medicine and BJC medical group and must maintain positive relationships. This position ensures the technology is built in a way to accurately support the scripting and validation of authorization and NOA. Without the above we are limited in our collection of payment. The role represent BJC with the highest standard of customer service, compassion and perform all duties in a manner consistent with our mission, vision, values, and service standards. Facilitates certain components of the patients' entrance into any BJC facility, including insurance validation, benefit verification, pre-certification & financial clearance. Responsible for ensuring that the most accurate patient data is obtained and populated into the patient record, particularly authorization data and status. This team member must possess exceptional attention to detail & maintain knowledge & competence with insurance carriers, Medicare guidelines & federal, state & accreditation agencies.
Responsibilities
Requires a high level of attention to detail along with a high degree of accuracy. Key components of the process include validation of the following: patient information, scheduled test/surgery information, and insurance information. Ensures that the authorization detail placed in the patient’s medical record is accurate. Expected to utilize critical thinking skills to research and resolve any mismatch in information which could involve various orders/scheduling, registration and insurance systems. Additionally, departmental processes around data capture must be followed and appropriate
Communication is a key. This position has high visibility and interaction with provider offices, insurance companies, as well as some patient interaction (typically phone calls for rescheduling appointments under the scope of the Ancillary Authorization process). This team member must communicate in a professional manner with particular emphasis on positive and respectful interaction with patients and offices. They must also be able to provide consistent excellent customer service in a variety of situations.
The ability to promote teamwork and employee engagement is everyone's responsibility. This team member will work to create an atmosphere of teamwork by contributing to opportunities to improve employee engagement and customer satisfaction. In all situations, they will engage others in a respectful and collaborative manner. They will seek opportunities for self-development (personal and technical) while achieving department objectives and goals.
This position is part of a multidisciplinary team which provides authorization support for multiple BJC Hospitals. May be responsible for supporting the Ancillary Authorization (scheduled outpatient services), Surgery Authorization (scheduled surgical procedures), or the NOA (Notice of Admission) processes within the BJC Pre-Arrival Team. As part of the authorization process, this team member will initiate contact with provider offices, payers and/or payer websites as well as access a variety of systems and tools to secure and validate authorization information. For Ancillary Authorizations, a review of medical records may be required if initiating the authorization request directly with a payer.
BJC has determined this is a safety-sensitive position. The ability to work in a constant state of alertness and in a safe manner is an essential function of this job.
Minimum Requirements
Education
High School Diploma or GED
Experience
2-5 years
Preferred Requirements
Education
Associate's Degree
Experience
5-10 years
Licenses & Certifications
CHAA
Benefits and Legal Statement
BJC Total Rewards
At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.
Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
Disability insurance* paid for by BJC
Pension Plan*/403(b) Plan funded by BJC
401(k) plan with BJC match
Tuition Assistance available on first day
BJC Institute for Learning and Development
Health Care and Dependent Care Flexible Spending Accounts
Paid Time Off benefit combines vacation, sick days, holidays and personal time
The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer