Job details
Job type full-time
Full job description
We`ve made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovateWe believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.
At ochsner, whether you work with patients every day or support those who do, you are making a difference and that mattersCome make a difference at ochsner health and discover your future today!
This job ensures the financial security of scheduled inpatient and outpatient (excluding ed) accounts for patients by obtaining/initiating prior authorization of ordered services, based on payer requirements, after benefits and eligibility have been determinedCoordinates with physician and/or staff for appropriate level of care setting and essential clinical documentation to support medical necessity of services ordered and works collaboratively with case management to establish level of care for direct admits and inpatient staysAlso acts as a resource for the revenue cycle staff within pre-service and performs duties under general supervision and following moderately complex procedures and guidelines.
$5k sign-on bonus available
Education
Required - registered nurse (rn) diploma
Work experience
Required - 1 year hospital based experience in the delivery of patient care
Certifications
Required - current rn license in the state of practice
Knowledge skills and abilities (ksas)
Must have computer skills and dexterity required for data entry and retrieval of patient information.
Must be proficient with windows-style applications and keyboard.
Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals.
Demonstrates good judgement and conflict resolution skills.
Ability to gather and disseminate information with a diverse range of people, either in person or over the phone.
Excellent interpersonal skills including the ability to work collaboratively with other departments and functional areas and handle difficult situations with professionalism.
Sound judgment in handling/escalating difficult situations.
Good organizational and time management skills including the ability work with minimal supervision.
Excellent decision making and critical thinking skills.
Good analytical skills with a strong attention to detail.
Proficiency in application of medical necessity criteria, standards of practice, and research regarding precertifcication guidelines.
Working knowledge and use of terminology associated with cpt and icd-10 coding, medicare guideline, hmo and ppo contracts and other insurance billing processes.
Job duties
Secures clinical documentation and performs pre-service medical necessity reviews to obtain prior authorizations.
Maintains professional and technical knowledge and certifications; ensures all regulatory requirements are met within department.
Assists in the day-to-day operations of the department.
Consistently supports company and business services goals and core values.
Performs other related duties as required.
The above statements describe the general nature and level of work onlyThey are not an exhaustive list of all required responsibilities, duties, and skillsOther duties may be added, or this description amended at any time.
Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.
This employer maintains and complies with its compliance & privacy program and standards of conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.
The employer is an equal opportunity employerAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.
Physical and environmental demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this jobReasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Light work - exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (constantly: activity or condition exists 2/3 or more of the time) to move objectsPhysical demand requirements are in excess of those for sedentary workEven though the weight lifted may be only a negligible amount, a job should be rated light work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligibleNote: the constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible.
Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid.
The incumbent has no occupational risk for exposure to communicable diseases.
Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated wasteThe risk level of exposure may increase depending on the essential job duties of the role.
Are you ready to make a difference? apply today!
Ochsner health endeavors to make our site accessible to all usersIf you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our hr employee solution center at 504-842-4748 (select option 1) or careers@ochsner.org This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.
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