Precertification Specialist / Scheduler Jobs

Company Overview:

Embrace the adventure of a career at Aspen Valley Hospital. Aspen Valley Hospital is a twenty-five-bed community hospital that represents the best of two worlds — the warmth and friendliness of a small town and the technical expertise of a major medical center. Our award-winning hospital, nestled in the heart of Aspen, CO, includes a team of more than 500 people dedicated to making a difference for our patients, families, and community. Nationally we are recognized for providing some of the most exceptional patient care of any hospital across the country.

This Position Offers:

Highly competitive pay, being part of a very cohesive & supportive team, and four of North America's top ski resorts at your doorstep. Our comprehensive benefits package, which can be viewed here, includes generous paid time off, health insurance within your first 30 days, and retirement. You will also be eligible to purchase discounted bus passes for transportation to and from work, discounted ski pass options, 457B, and a number of AVH hosted programs including cell phone discounts and computer software.

Pay range for new hires: $23.00 - $36.74 /hr

Hire-in rates of pay are based upon the relevance of years of experience, education and certifications. Our talent acquisition team will help you understand how your direct experience will be considered.

Job Overview:

To assist in scheduling patient encounters for all clinical service departments using Meditech Scheduling and B/AR module. To act as liaison between Hospital departments to effectively coordinate scheduling of tests and procedures. Responsible for pre-authorization function to assure accurate and timely payor information and fiscal responsibility.

Primary Scope of Responsibilities:

• Records pertinent documentation in accordance with regulatory requirements, professional standards and hospital policy.
• Mammo - interviews & schedules patients using: symptoms/screening, Insurance/Komen or other Grants, implants, & requests for previous films. Assist Breast Liaison with follow-up. Keeps current on all grant criteria & requirements.
• Works with other PFS staff to ensure fiscal management of appointments. Stays current on Medicare & insurance requirements, ensuring ABN's & insurance waivers & pre-certs are completed & communicated to patient & scanned.
• Understands and complies with all Hospital, patient confidentiality, ABN’s and insurance waivers. Participates in trainings & staff meetings. Reads daily summary reports & emails to be aware of changes.
• Utilizes computerized scheduling and B/AR modules to maximize benefit for AVH and customers. Adapts software to meet needs.
• Provides assistance to other departments as needed.
• Schedules and pre-certifies all Physical Therapy patients-at all AVH locations. Reviews and monitors CAP requirements and ABN’s for Medicare patients. Pre-certify and/or check for MCR ABN on all patients with scheduled lab tests-at all AVH locations. As above does all pre-certification, insurance authorizations and waivers, required ABN’s and CAPS.
• Accurately schedules appointments, choosing appropriate appointment types, and correct data entry. Professional & responsive communication with physicians, patients, and departments.
• Adheres to federal, state and hospital rules and regulations concerning HIPAA privacy and security.
• Fiscal responsibility including reviewing and completing ABN’s, Insurance authorizations/waivers, and ensuring completed precertification as needed.
• Produces day end reports & distributes. Includes reviewing scanned orders, correct procedure vs. actual order, and ABN if needed has been processed & distributed accordingly.
• Participates in required training for compliance related activities (HIPAA, Compliance, Patient Safety, TJC, etc.)
• Follows Hospital compliance plan and policies, including the Code of Conduct.

Minimum Qualifications & Requirements:

• Ability to read and communicate effectively in English
• Ability to work independently
• Ability to concentrate and show attention to detail
• 2-3 years of experience in related healthcare field preferred
• Relatively high degree of analytical abilities
• Strong interpersonal skills required
• Spanish preferred
• High School Diploma or GED, preferred