Specialist-Patient Placement

Job Summary
 

Recommends the most efficient, cost-effective utilization of resources within the continuum of care, prior 
to the delivery of services. Evaluates, assesses, plans, and facilitates a plan of care. Obtains/Validates 
insurance prior authorizations and pre-certification for inpatient and/or outpatient healthcare services. 
Some overtime and call back is required. This position is under the general direction of the leadership of 
Centralized Patient Access or Baptist Connected Center-Corporate. Performs other duties as assigned.

Job Responsibilities

• Assesses and evaluates clinical and financial information available and recommends the most appropriate setting for service delivery, including level of care in order to optimize resource consumption and reimbursement.

•   Pre-certifies patient care services that require precertification, as identified, in a timely, efficient manner, in order to optimize reimbursement for the patient, as well as health care providers.

• Communicates recommendations, clinical information, and fiscal information to appropriate internal and external customers in order to facilitate optimal delivery of services and customer satisfaction. 

•  Participates in the planning, data collection, and analysis phases of performance improvement activities in order to maximize the patient placement/precertification process. • Completes assigned goals

Experience

Minimum Required

 5 years of business/clinical experience in a healthcare setting with a focus in patient access, business office, and/or case management areas.

Preferred/Desired 

8 years of business/clinical experience in a healthcare setting with a focus in patient access, business office, and/or case management areas.

Special Skills
 Minimum Required 
Excellent communication skills. Advanced computer literacy skills.
 

Licensure Description Minimum 

Preferred/Desired LPN or CMA