If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One!
We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associates can grow their career caring for others. For over a century, we’ve served the health care needs of the people of Memphis and the Mid-South.
Responsible for maintaining flow of patient information to all departments and agencies, including physician orders, verification of insurance status, certificates of medical necessities (CMNs), prior authorizations (PARs) and coordination of home medical equipment (HME) services. Provides customer-centered service to inquiries from potential and actual customers, both internal and external. Responsible for clerical duties to include data entry. Models appropriate behavior as exemplified in The Methodist Mission, Vision and Values.
Working at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence.
A Brief Overview
Responsible for maintaining flow of patient information to all departments and agencies, including physician orders, verification of insurance status, certificates of medical necessities (CMNs), prior authorizations (PARs) and coordination of home medical equipment (HME) services. Provides customer-centered service to inquiries from potential and actual customers, both internal and external. Responsible for clerical duties to include data entry. Models appropriate behavior as exemplified in The Methodist Mission, Vision and Values.
What you will do
- Receives referral for services and processes orders from physicians and customers. Receives pertinent information on potential patients and contacts appropriate locations and/or departments for services.
- Insures that complete data is obtained from the customer (patient, physician, etc) and completes for submission.
- Identifies additional services/supplies based on patient/customer needs that may be required and makes recommendations.
- Provides customer assistance, including quoting prices.
- Verifies patient/customer insurance coverage with insurance company. May negotiate pricing for various services, as determined.
- Obtains a prior authorization/PAR or a certificate of medical necessity/CMN when required by insurance company or payer
- Offers assistance to patients, patients' families, customers, physicians, and other referral sources that are inquiring.
- Secures all needed data/signatures required to meet payor, state licensure, Board of Pharmacy, CHAP, PHIAA, and FDS requirements. Completes "Patient Information Guide", as appropriate. Encourages patients/customers to complete "Patient Satisfaction Survey" for quality monitoring purposes.
- Communicates current patient information to appropriate departments and coordinates orders that have been received from referral sources.
- Assists individuals with problems, questions, and concerns regarding programs and services available through HME.
- Enters referrals into computer and updates each entry with corrected data, as indicated.
- Performs other job functions as requested or needed.
Education/Formal Training Requirements
- Required - High School Diploma or Equivalent
Work Experience Requirements
- Required - Healthcare or medical office environment 3-5 years
Knowledge, Skills and Abilities
- Knowledge of quality and business or office management preferred.
- Ability to apply problem solving techniques to assess and interpret medical records to a degree that would support independent work and possess excellent communication skills.
- Good customer service skills.
- Ability to handle stressful and emotional situations in relationship to patients in acute distress, physicians, or families of dying patients.
- Ability to work without close supervision and to exercise independent judgement.
- Ability to set priorities, coordinate multiple tasks, organize tasks, maintain workflow, and prepare complex written materials.
- Proficiency in database management and word processing.
- Knowledge of third party payors as acquired through job experience with insurance customer service or billing.
Supervision Provided by this Position
- There are no supervisory responsibilities assigned to this position.
Physical Demands
- The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
- Must have good balance and coordination.
- The physical requirements of this position are light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
- The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
- The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work.
- Must have transportation to deliver care in the home setting.
Our Associates are passionate about what they do, the service they provide and the patients they serve. We value family, team and a Power of One culture that requires commitment to the highest standards of care and unity.
Boasting one of the South's largest medical centers, Memphis blends a friendly community, a thriving and growing downtown, and a low cost of living. We see each day as a new opportunity to make a difference in the lives of the people in our community.
