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Associate Clinical Authorization Specialist - LVN
Category: Other
  • Your pay will be discussed at your interview

Job code: lhw-e0-85762828

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St. Joseph Health

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  Job posted:   Tue Mar 13, 2018
  Distance to work:   ? miles
  1 Views, 0 Applications  
Associate Clinical Authorization Specialist - LVN
Summary:The Associate Clinical Authorization Specialist is responsible for obtaining insurance authorizations and processing requests for services within a timely manner. The Associate Clinical Authorization Specialist communicates authorizations to the Clinical Managers, Intake Coordinators and Home Health Case Managers. Acts as a patient advocate when requesting authorizations.Responsibilities:o Reviews tasks and clinical documentation from the Clinician or Clinical Manager regarding patient status and need for further authorizations.o Creatively communicate to the insurance case manager the needs of the patient in order to obtain authorizations. o Communicates with Clinician, Clinical Manager, and Intake Coordinator the number of visits and duration that has been authorized.o Receives reports and frequently interacts with clinicians via phone and in person. Forwards information related to outcomes to the Home Health Clinical Manager.o Documents information into EMR and scans pertinent information under electronic patient chart.o Understands both federal and state regulations applicable to Home Care Services. o Understand and implements the balance of patient advocacy with fiscal responsibility.o Maintains an on-going record of authorizations and their expiration dates and communicates this with the clinical team.o Annually completes Compliance Education and understands applicable policies.o Attends meetings as needed and requested.o Obtains insurance verification, authorization and certification requirements for new patients and communicates this information quickly to Intake team.o Obtains insurance authorizations for existing patients in a timely manner which may include reviewing clinical documentation, communicating patient needs and acting as patient advocate for care.o Responsible for obtaining patient financial responsibility information and communicating this to staff and to the patient as needed.o Clearly communicates required information to the Clinical Managers, Intake Coordinators and Home Health Case Managers as needed in a concise and efficient manner.o Supports Intake team including understanding all other Intake roles and can transition between roles as needed.Minimum Position Qualifications:o Education: Complete necessary education to attain LVN Licensure in state of California. o Experience: 1 year of License Vocational Nurse experience. o Licenses: Current LVN license.Preferred Position Qualifications:o Background in insurance and/or case management.o One year experience with Electronic Health Records.

St. Joseph Home Care Network (SJHCN) is a Home Health ministry of St. Joseph Health, serving three Northern California counties; Humboldt County, Napa County and Sonoma County. Our networks of compassionate, highly skilled employees are dedicated to putting the patient first to improve the health of individuals and families in our community. The Home Health caregivers assist in restoring a patient's optimal health and support the family by going into the home and ministering to the physical, psychological and spiritual needs of the patient and family members. Our home care services are a literal representation of reaching out to our community to care for our dear neighbors.

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