Compile, maintain, and support timely and accurate patient health information at KHS. Ensure information is available to authorized users when needed, maintain storage and retrieval of health information, and assist with monitoring and resolving deficiencies. Support accurate data entry for clinical, financial, and statistical purposes.
Essential duties
- Receive prior authorization requests through the EHR, phone, or fax and monitor them closely.
- Process referrals and submit medical records to insurance carriers to expedite prior authorization.
- Manage correspondence with insurance companies, physicians, specialists, and patients.
- Assist with medical necessity documentation to support approval decisions.
- Review accuracy and completeness of requested information and confirm all supporting documents are present.
- Review denials and follow up with providers to gather information needed for appeals.
- Prioritize incoming authorizations based on patient urgency.
- Maintain records according to regulatory and facility guidelines.
- File, scan, and organize documents according to applicable systems.
- Ensure quality and integrity of scanned data.
- Enter and retrieve data using computer systems and department software.
- Create correspondence and reports as needed.
- Answer phones, route calls, take messages, and assist customers promptly and courteously.
- Interact positively with patients, families, staff, and the public.
- Attend meetings and committees as requested.
- Maintain current knowledge and skills through training and workshops.
- Adapt to variable workloads and job duties.
- Maintain confidentiality of patient, client, and facility information.
- Perform other duties as assigned.
Requirements & Qualifications
- High school diploma or equivalent required.
- Associate degree in Health Information Management preferred.
- One year of related experience and/or training, or an equivalent combination of education and experience.
- Basic computer skills.
- Typing and computer proficiency.
- Strong organizational skills and attention to detail.
- Excellent interpersonal and communication skills.
- Basic knowledge of medical record content.
- Knowledge of CPT, ICD-10, and HCPCS codes.
- Ability to meet benchmarks and deadlines.
- Ability to present information and respond to questions effectively.
- Ability to solve practical problems and interpret instructions in written, oral, diagram, or schedule form.
Location
Nebraska, US
Employment Type
Not specified
Experience Level
Associate
Remote work allowed
No
Posted
3 weeks ago