Founded in 1906, McLeod Health is a locally owned and managed, not for profit organization supported by the strength of more than 900 members on its medical staff and more than 2,900 licensed nurses. McLeod Health is also composed of approximately 15,000 team members and more than 90 physician practices throughout its 18-county service area. With seven hospitals, McLeod Health operates three Health and Fitness Centers, a Sports Medicine and Outpatient Rehabilitation Center, Hospice and Home Health Services. The system currently has 988 licensed beds, including Hospice and Behavioral Health. The hospitals within McLeod Health include: McLeod Regional Medical Center, McLeod Health Dillon, McLeod Health Loris, McLeod Health Seacoast, McLeod Health Cheraw, McLeod Health Clarendon and McLeod Behavioral Health.
Essential Job Responsibilities/Expectations
1. Assists the Auth Central Supervisors ensuring timely authorizations are secured for the Auth Central scope of work.
2. Proactively partners and serves as a SME to the Patient Access Specialists team with educational and training updates, as needed.
3. Partners and supports all 7 locations as well as the ancillary departments. This also includes partnering with all MPA (McLeod Physician Associates) practices as well as non-McLeod owned practices. Also, assists in growing the Auth Central body of work towards centralization.
4. As needed in staffing, utilizes all tools and resources furnished via manual authorization/payer grids and payer portals. Assists in the routine and frequent updating of all resources and helps cascade to the Auth Central Team.
5. Supports the Auth Central Supervisors to ensure each patient’s account is accurately and timely worked thereby ensuring hospital reimbursement and reductions in patient wait times or likelihood of rescheduling.
6. Participates in the monthly denials meetings in an effort to identify areas of opportunity.
7. Supports the Auth Central Team helping ensure all patients have been financially vetted with the work queues 3 days out or greater.
8. Participates in Payer webinars for information gathering and learning purposes.
9. Audits inbound and outbound calls as needed for quality review and denial purposes.
10. Maintains a professional image and exhibits excellent customer relations to patients, visitors, physicians, and co-workers in accordance with our Service Excellence Standards and Core Values.
Job Requirements
Qualifications/Training:
• Patient Access Auth Central authorization experience
• Experience with Windows based computers and Microsoft Office
• Written and verbal communication skills with persons of all ages and diverse backgrounds
• Problem solving and performance improvement skills
• Revenue Cycle knowledge and the understanding of how this work impacts the business