POD Assistant
Company: Hines & Associates Inc
Location: Rockford
Posted on: October 26, 2024
Job Description:
Description:This non-clinical administrative staff person will
perform steps of the certification process including the
acquisition of non-clinical and structured clinical data, review of
service requirements, and file maintenance. This individual will
perform scripted clinical screening that does not require
evaluation or interpretation of clinical information. This position
performs activities that allow the first level reviewers to
primarily allocate their time to interpreting clinical data,
applying review criteria, making certification determinations, and
perform discharge planning. The individual is non-licensed and
therefore is only responsible for making non-clinical
administrative judgments. The individual is under the supervision
of a licensed registered nurse, and all calls requiring clinical
assessment are forwarded to the RN for review.
JOB DUTIES:
- Makes outgoing calls to hospitals to determine if patients are
still in-house, request discharge dates, disposition and retro,
initial or concurrent clinical reviews. The individual will not be
responsible for taking clinical reviews directly from hospital
reviewers or nurses. Instead, requesting for call back with
clinical or transferring the call to a first level reviewer.
- Send faxes to hospitals with request for clinical reviews
and/or discharge needs may also be necessary.
- Monitors and attaches faxes on the fax server as assigned.
- Transfers all messages and clinical reviews from voice mails
into the UR system. All simple messages may be deleted from the
voice mail, but all clinical review messages must be left on voice
mail so UR nurse can review and supervise the clinical data entered
into the UR system by the individual. Once the assistant is proven
adept at clinical data transfer, permission will be granted to
remove voice mail messages once entered.
- Performs any scripted clinical screening as assigned following
the Policy and Procedure for Scripted Clinical Screening that does
not require evaluation or interpretation of clinical information.
In the event that the request requires interpretation, the request
will be forwarded to a first level reviewer.
- Verifies that a provider is in the network or identifies
potential PPO providers, and clarifies incomplete or contradictory
non-clinical data.
- Notifies providers of certification and reads the disclaimer,
produces and sends to print batch certification letters after
completion of scripted screenings
- Communicates with MD offices, hospital medical records or UR
departments, case managers and customers as needed.
- Documents all activities in the UR file according to
procedure
- Assist intake administrative staff as staffing
necessitates
- Other duties as assigned.PM21Requirements:EDUCATION: High
School Diploma or equivalent with some post-secondary education
desirable. Courses in medical terminology preferred. SKILLS:
Knowledge of computers along with fluent keyboarding, data entry in
databases, word processing, and multiple line telephone systems.
Bi-lingual helpful but not required.EXPERIENCE: Experience in the
health care industry such as medical transcription. Successful
completion of the URA orientation program and maintenance of
minimal QA standards. 1-2 years experience or relevant education in
the health care industryPERSONAL QUALIFICATIONS: Helpful and
friendly telephone personality. Ability to proof written material
accurately, accurate data entry ability. Ability to organize a
large variety of tasks and prioritize as directed by UR Manager.
Ability to work with a variety of professional staff and provide
clerical backup as needed for that staff. Understanding of customer
service.
PI140256c88e0f-37248-35324900
Keywords: Hines & Associates Inc, DeKalb , POD Assistant, Other , Rockford, Illinois
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