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POST DATE 9/16/2016
END DATE 10/11/2016
Einstein Healthcare Network
JOB DESCRIPTIONPosition Description
SINCE 1959, MOSSREHAB HAS PROVIDED OUR PATIENTS WITH A BREADTH OF EXPERTISE UNRIVALED IN THE REGION. SUPERIOR CLINICAL EXPERTISE, NATIONALLY RECOGNIZED REHABILITATION SPECIALISTS, UNSURPASSED DIAGNOSTIC CAPABILITIES, A PASSION FOR ADVOCACY, A PATIENT CENTERED TEAM PHILOSOPHY AND A QUEST FOR CONTINUOUS IMPROVEMENT. THESE ARE THE QUALITIES THAT HAVE EARNED MOSSREHAB ITS OUTSTANDING REPUTATION AT THE LOCAL, REGIONAL AND NATIONAL LEVELS AND ENABLE TO US TO ATTRACT AND RETAIN HIGHLY MOTIVATED, GIFTED REHABILITATION PROFESSIONALS. IN FACT, U.S. NEWS & WORLD REPORTS HAS CONSISTENTLY RANKED US AMONG THE NATION S BEST REHABILITATION FACILITIES. WE WERE ALSO NAMED ONE OF THE BEST EMPLOYERS IN THE PHILADELPHIA AREA THIS YEAR, COME FIND OUT WHY! EINSTEIN HEALTHCARE NETWORK PROMOTES WELLNESS. RESEARCH HAS SHOWN THAT SMOKING IS DANGEROUS TO THE HEALTH OF SMOKERS AND TO OTHERS. EINSTEIN CAMPUSES ARE TOBACCO AND SMOKE FREE.
RESPONSIBILITIES OF THIS POSITION INCLUDE:
* Coordinating timely financial clearance of all MROC patients for all outpatient locations.
* Utilizing electronic access as well as phone contact to obtain all required information related to coverage, co-pays, deductibles, capitation limitations, out of cap approvals, out of network coverage, referrals and authorizations for patient insurers.
* Documenting all information related to required insurance information.
* Informing Admin Coordinators at all locations of clearance status as required via phone or fax.
* Receiving and conveying referral and authorization information from Clinical staff to insurance providers.
* Communicating referrals, authorizations or time extensions to clinical staff upon receipt.
* Reconciling pending authorizations and referrals with insurance providers.
* Retrieving clearances, authorizations, referrals and associated documentation required to appeal denials.
* Assuring payment of cases totaling approximately 30 million dollars annually.
* Attending finance denial meetings supplying remediation for denied cases.
* Attending all insurer contract updates, or reads bulletins and confirming with Contract Management Dept.
* Communicating all new information related to contracts to MossRehab Clearance coordinators in a timely manner.
* Conducting random reviews of clearance coordinators work, reviewing and critiquing as necessary.
* Implementing new electronic media that becomes available for financial clearances.
* This position requires providing service to the following age population(s) all ages in a manner that demonstrates an understanding of the functional/developmental age of the individual served.
IF YOU POSSESS THE FOLLOWING, PLEASE APPLY:
* High School Diploma required, Associates Degree preferred.
* Previous healthcare insurance experience required.
* Knowledge of rehabilitation services required.
* 3 - 6 years experience with financial clearances, both electronically and telephonically required.
* Good computer skills - using Windows products.
* Excel experience required.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.