Financial Case Manager Assistant - Patient Access Management (FT- 1 FTE, Day Shi

Must reside in Montana!

Position Summary:

Assist in coordinating the pre-authorization and assistance programs. Provides timely communication to the providers and nursing staff and patients as it relates to insurance guidelines and pre-authorization process. Assists in assessment of patient financial needs. Provides information regarding available patient assistance programs. Assists in the claims denial process for insurance carriers and develops an appropriate appeals response as necessary.

Minimum Qualifications:

Required

• High School diploma

Preferred

• 1 year in a hospital or outpatient clinic setting
• Previous ICD-10 and CPT coding
• Previous experience in medical pre-authorization, case management and / or financial counseling

Essential Job Functions:

In addition to the essential functions of the job listed below, employees must have on-time completion of all required education as assigned per DNV requirements, Bozeman Health policy, and other registry requirements.

• Verifies eligibility and benefit information with insurance companies and communicates with physicians and staff before services are scheduled.
• Collaborates with staff and referring clinics regarding pre-authorizations.
• Collaborates with staff regarding denials.
• Reviews patient assistant program guidelines for potential patient enrollment.
• Communicates and collaborates with Clinical Operations Manager.

Knowledge, Skills, and Abilities

• Demonstrates sound judgement, patience, and maintains a professional demeanor at all times
• Strong interpersonal, verbal and written communication skills
• Creativity, problem analysis and decision making
• Ability to work varied shifts
• Exercises tact, discretion, sensitivity and maintains confidentiality
• Computer applications, MS Office, EMR, internet applications and standard office equipment
• Ability to analyze, organize and prioritize work while meeting multiple deadlines
• Self-directed, completes assignments accurately, thoroughly and with minimal oversight
• Strong emotional intelligence, interpersonal and teamwork skills

Schedule Requirements

• This role requires regular and sustained attendance.
• The position may necessitate working beyond a standard 40-hour workweek, including weekends and after-hours shifts.
• On-call work may be required to respond promptly to organizational, patient, or employee needs.

Physical Requirements

• Lifting (Rarely – 30 pounds): Exerting force occasionally and/or using a negligible amount of force to lift, carry, push, pull, or otherwise move objects or people.
• Sit (Continuously): Maintaining a sitting posture for extended periods may include adjusting body position to prevent discomfort or strain.
• Stand (Occasionally): Maintaining a standing posture for extended periods may include adjusting body position to prevent discomfort or strain.
• Walk (Occasionally): Walking and moving around within the work area requires good balance and coordination.
• Climb (Rarely): Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like using feet and legs; may also use hands and arms.
• Twist/Bend/Stoop/Kneel (Occasionally): Twisting, bending, stooping, and kneeling require flexibility and a wide range of motion in the spine and joints.
• Reach Above Shoulder Level (Occasionally): Lifting, carrying, pushing, or pulling objects as necessary above the shoulder, requiring strength and stability.
• Push/Pull (Occasionally): Using the upper extremities to press or exert force against something with steady force to thrust forward, downward, or outward.
• Fine-Finger Movements (Continuously): Picking, pinching, typing, or otherwise working primarily with fingers rather than using the whole hand as in handling.
• Vision (Continuously): Close visual acuity to prepare and analyze data and figures and to read computer screens, printed materials, and handwritten materials.
• Cognitive Skills (Continuously): Learn new tasks, remember processes, maintain focus, complete tasks independently, and make timely decisions in the context of a workflow.
• Exposures (Rarely):Bloodborne pathogens, such as blood, bodily fluids, or tissues. Radiation in settings where medical imaging procedures are performed. Various chemicals and medications are used in healthcare settings. Job tasks may involve handling cleaning products, disinfectants, and other substances. Infectious diseases due to contact with patients in areas that may have contagious illnesses.

*Frequency Key: Continuously (100% - 67% of the time), Repeatedly (66% - 33% of the time), Occasionally (32% - 4% of the time), Rarely (3% - 1% of the time), Never (0%).

The above statements are intended to describe the general nature and level of work being performed by people assigned to the job classification.They are not to be construed as a contract of any type nor an exhaustive list of all job duties performed by individuals so classified.