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Riverview Health

Riverview Health is a healthcare provider that includes a full-service, 156-bed hospital in Noblesville and a 16-bed hospital in Westfield, along with multiple ER and urgent care facilities. It offers comprehensive inpatient and outpatient services across more than 35 specialties and has received recognition for clinical excellence, including awards for orthopedic surgery and patient experience. As a significant employer in Hamilton County, Riverview Health is committed to compassionate care and community health.

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 Job Summary
 
 
 
 The Authorization Specialist is responsible for ensuring that payers are prepared to reimburse Riverview Health for scheduled services in accordance with the payer-provider contract. The Specialist contacts payers to request service authorization and may collect clinical, financial and/or demographic information from clinics, hospital departments and/or patients as needed.
 
 
 
 Job Responsibilities
 
 
 
 <ul>
 <li>
 Verifies patients&rsquo; insurance and benefits information
 </li>
 <li>
 Obtains prior authorizations from third-party payers in accordance with payer requirements. Identifies patients who will need to receive Medicare Advance Beneficiary Notices of Noncoverage (ABNs).
 </li>
 <li>
 Contacts patients to gather demographic and insurance information as needed, and updates patient information within the EMR as necessary.
 </li>
 <li>
 Works with other departments to gather the clinical information required by the payer to authorize services. Maintains accurate records of authorizations within EMR.
 </li>
 <li>
 Develops price estimates for patient out-of-pocket responsibility.
 </li>
 <li>
 Refers accounts to financial counseling as needed if authorization is not obtained. Works with business office staff to support appeal efforts for authorization-related denials.
 </li>
 <li>
 Reviews surgery schedules to ensure Medicare patients with IP-only procedures have the appropriate authorization and order.
 </li>
 <li>
 Complies with HIPAA regulations, as well as Riverview Health policies and procedures regarding patient privacy and confidentiality.
 </li>
 <li>
 Maintains professional tone at all times when communicating with patients and payer representatives.
 </li>
 <li>
 Coordinates re-education to practices or hospital departments when orders are incorrect or not supported by the given diagnosis.
 </li>
 <li>
 Performs other duties as requested.
 
 
 </li>
 </ul>
 
 Education Requirements
 
 
 
 <ul>
 <li>
 Minimum: Associate degree in healthcare or business administration and/or related coursework, or comparable experience
 </li>
 <li>
 Preferred: Experience in Epic
 
 
 </li>
 </ul>
 
 Experience Requirements
 
 
 
 <ul>
 <li>
 Minimum: Two years of experience in a healthcare setting performing related tasks
 </li>
 <li>
 Preferred: Five years of experience in a healthcare setting performing related tasks
 
 
 </li>
 </ul>
 
 License/Certification Requirements
 
 
 
 <ul>
 <li>
 None
 
 
 </li>
 </ul>
 Education
 
 
 
 Required
 
 
 
 <ul>
 <li>
 Associates or better in Other
 
 
 </li>
 </ul>
 Equal Opportunity Employer
 
 
 This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
</div>

Authorization Specialist

<div>Job Summary

The Patient Care Tech provides direct care to patients, aiding them with basic daily life needs such as feeding, bathing, dressing, etc. The PCT measures daily vitals, monitors the patient behavior and mood, and reports this information through both charting and communication with other members of the patient care team. The Patient Care Tech is also responsible for maintaining clean, organized hallways, rooms, and equipment.

Job Responsibilities
<ul>
<li>Observe, document, and communicate significant findings, and any procedure results, to the Registered Nurse to minimize and prevent delays or complications in patient care.</li>
<li>Document pertinent patient care data on appropriate forms, and/or within the electronic patient chart, that meets legal, ethical, and procedural guidelines and requirements.</li>
<li>Assist in the provision of routine hygienic, nutritional, and comfort needs of patients such as, but not limited to: bathing; distributing fluids and nourishments; feeding; ambulating; changing bed linens; oral care; grooming; shampooing hair; toileting; etc.</li>
<li>Perform routine clinical tests and procedures such as, but not limited to: vital signs; hot/cold packs; measuring and documenting patient input and output; weighing patients; bladder ultrasound; and suction set up.</li>
<li>Function as testing personnel under CLIA 1988 regulations as related to point of care testing if applicable.</li>
<li>Perform basic nursing support tasks such as but not limited to: answering call lights; transporting patients; transporting specimens; assisting with patient transfers; and range of motion.</li>
<li>Assist physicians and other team members with treatments and procedures as directed.</li>
<li>Perform unit support functions, such as but not limited to: answering the phone; retrieving and transporting supplies and equipment; orienting patient to room upon admission, maintaining clean, clutter free hallways, rooms, etc.</li>
<li>May function as a patient sitter under the direction of the nursing supervisor to ensure that patient&rsquo;s safety as they have been identified as a risk of harm to self/others. Requires notification and reassignment of other staff member during break period to ensure the patient is not left unattended.</li>
<li>Responsibilities include patient care activities within the CNA/Student Nurse Tech&rsquo;s scope of practice, while always ensuring supervision of the patient.</li>
<li>Other duties as assigned.</li>
</ul>
Education Requirements
<ul>
<li>Minimum: High School Diploma or equivalent; or proof of high school graduation eligibility within six months.</li>
</ul>
Experience Requirements
<ul>
<li>Minimum: None</li>
<li>Preferred: One (1) year in a hospital environment providing similar health services as a CNA.</li>
</ul>
License/Certification Requirements
<ul>
<li>Minimum: Basic Life Safety within 90 days of hire into the position (American Heart Association)</li></ul></div>

Patient Care Tech Rehab Full-Time Nights

Join Riverview Health and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Riverview Health

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Authorization Specialist

Patient Care Tech Rehab Full-Time Nights