PRN Post-Acute Patient Access Specialist - Pre-Cert

Company: ProMedica Senior Care
Location: Commerce City
Posted on: June 25, 2022

Job Description:

DescriptionProMedica Senior Care provides a range of services, including skilled nursing care, assisted living, post-acute medical and rehabilitation care, hospice care, home health care and rehabilitation therapy.Job SummaryThe PRN Post-Acute Patient Access Specialist - Pre-Cert role is responsible ffor managing/obtaining Managed Care authorization from key hospitals and other care settings (sites to be determined as part of the division market strategy) and ensuring a smooth transition of care for patients discharging from a care setting to our centers. Additionally, the Post-Acute Patient Access Specialist - Precert will develop a strong relationship with the key Managed Care or Third Party Administrator personnel and identify new opportunities for partnering and growth.Responsibilities:Processes inquiries received via referral management system, at a minimum rate of 5-15 inquiries per day, with an average response time rate of 15 minutes or less from the time the precert specialist assigned.Manages referrals in conjunction with the MCO/TPA to ensure approval for admissions are received timely.Makes IMPACT business calls to Managed Care Organizations to better understand their work flow to secure authorization timely, gain in-sight into their expectation of SNF criteria, and to understand program and service needs; in order to effectively communicates those needs with ProMedica Senior Care leadership.Develops relationships by completing integration calls to precert personnel, utilization review personnel, MCO/TPA supervisors, and other professionals and related contacts at the MCO/TPA leading to an efficient and consistent process processing authorizations. In return for your expertise, you'll enjoy excellent training and unlimited opportunities to learn and grow. Be a part of the team leading the nation in healthcare.Location374 - ProMedica Skilled Nursing and Rehabilitation - Denver, COEducational RequirementsBachelor degree preferred; Sales and medical training, required.Position RequirementsTwo years of experience with sales and marketing knowledge, required; Strong medical assessment skills; Prior experience with an insurance company, private case management company, or HMO, preferred. Familiarity with long term care and/or subacute care, useful. Strong oral and written communications skills.

Keywords: ProMedica Senior Care, Commerce City , PRN Post-Acute Patient Access Specialist - Pre-Cert, Other , Commerce City, Colorado