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Berkshire Health Systems Authorization / Referral Specialist in Pittsfield, Massachusetts

  • DEFINITION/PRIMARY FUNCTION

  • Responsible for selected fiscal aspects of Central Scheduling accounts to prepare account for billing, assuring maximum payment on a timely basis and maintenance of accurate history files. Responsible for daily review of scheduled patients to assure a solid source of re-imbursement is in place. Responsible for the inquiries and response of the appeals process. Responsible for all inquiries from patients, families, professional and institutional providers, inter and intra department staff, Government and third party payers, case management companies, patient accounting, clinical department staff, and case managers until the time of billing. Acts as a patient advocate for patients with self pay liabilities by informing them of hospital collection policy, and referring them to the Advocacy for Access Office.

  • POSITION QUALIFICATIONS (Minimum qualifications are required unless stated otherwise.)

  • Experience:

  • Three years experience in a hospital admitting/billing office required. Knowledge of all major third party payors, including Medicare, Medicaid, and Blue Cross required, three to five years experience with the scheduling and Admitting Meditech modules and/or AllScripts scheduling and registration modules.

  • Education and Training:

  • Two years of college(business/health related)or equivalent work experience. Medical terminology preferred.

  • License, Certification & Registration:

  • Other Requirements:

  • Strong typing ability (40 wpm) and computer skills (ie. Personal Computer - Windows). Manual dexterity necessary for typing/computer purposes.

  • Professional presentation with exceptional Customer Service skills including oral, written and telephone communication required.

  • Ability to speak the English language in a clearly understandable manner.

  • Proven ability to interact appropriately with hospital staff and physicians, acting as a role model in representing the Medical Center to the community.

  • Ability to consistently maintain high level of confidentiality.

  • Demonstrated ability to handle stressful situations calmly and rationally, control potentially difficult people/situations, and meet deadlines, even with high volume of interruptions.

  • Demonstrated ability to work independently, prioritize duties and manage time with a minimum of supervision.

  • Demonstrated high level of professional judgement, problem solving and strong organizational skills.

  • Ability to troubleshoot and maintain proper operation of business equipment.

  • Proven ability to learn quickly as technology/insurance requirements change.

  • Proven ability to be an effective team member.

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