Company :

Job Description : 

GENERAL OVERVIEW:

Responsible for optimizing bed utilization and ensuring appropriate patient placement within AHN facilities. This involves leveraging triage notes and hospital protocols to assign patients to the most clinically appropriate unit, verifying insurance coverage and eligibility through multiple channels payer contacts, online resources, and electronic verification systems, to advise on the most appropriate facility, and proactively addressing any placement challenges to ensure efficient patient flow

ESSENTIAL RESPONSIBILITIES

• Leverages Electronic Medical Record (EMR) registration and bed request data to identify and resolve bottlenecks in patient flow, proactively optimizing bed utilization and improving patient throughput.20%

• Proactively identifying and resolving potential patient placement challenges.10%

• Maintaining accurate EMR of bed assignments and patient insurance information.10%

• Facilitates smooth and efficient patient transfers by collaborating and partnering with physicians, care managers, hospital operations, clinical teams, and referring hospitals, ensuring effective communication and coordination throughout the notification process.15%

• Proactively monitors bed availability and cleanliness in assigned units/facilities, anticipating needs and expediting patient placement to minimize wait times10%

• Ensures timely resolution of delays and concerns impacting patient flow by promptly escalating issues to the Transfer Center clinical team10%

• Appropriately field incoming transfer request calls5%

• Developing and implementing strategies to optimize bed utilization and reduce wait times.10%

• Precept/mentor new employees5%

• Analyzing data related to patient placement to identify areas for improvement in efficiency and effectiveness5%

• Other duties as assigned or requested. 

QUALIFICATIONS:

Required

• High School/GED or six months or equivalent experience

• Experience operating a PC, using multiple screens, and various software application.

• Experience using a multichannel phone system

• Medical terminology and insurance verification experience

• Call Center Experience

Substitutions

• OR, one previous year of related experience, preferably within a medical setting, financial services, or a high volume fast paced customer service area. 

Preferred

• Associates Degree

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

California Consumer Privacy Act Employees, Contractors, and Applicants Notice