Screens referrals for appropriateness of services requested by a referral source. Assesses, plans, and evaluates the needs of the patient and will collaborate and communicate with providers, case manager, nursing staff and entire multi-disciplinary care team to ensure that all necessary documentation is obtained for payer coverage. Acts as point of contact for patient/family/legal representative and communicates any changes in the patient's medical condition that may impact their care plan and the outcome of the referral received for the specific service need. Determines priorities of care based on physical and psychosocial needs, as well as factors influencing patient flow through the system. Responsible for prior authorizations for the specialty clinic.
DUTIES AND RESPONSIBILITIES:
Receives and processes messages from the neurology service line phone and email/web access points.
Provides telephone triage of patients and coordinates treatments/appointments with providers.
Evaluates and prepares all cases for surgery ensuring readiness and completeness.
Coordinates the collection and distribution of key clinical, demographic and treatment information for patients, to providers, insurers, and consultants per regulations and guidelines.
Physician liaison for all out of area referrals.
Works collaboratively with all providers and their offices to provide excellent customer service.
Works closely with Patient Business service to assure that prepaid policies and procedures are followed.
Maintains department records and files.
Coordinates and develops programs that assist the delivery of the highest quality, effective and efficient care.
Includes the development and delivery of education to patients, insurers, physicians and staff.
Assists in cost containment through appropriate ordering and conserving of supplies and equipment.
Cooperates with other personnel to achieve office/clinic objectives, maintains good employee relations.
Demonstrates knowledge of healthcare plans, procedural costs.
Demonstrates the ability to assist physicians with procedures in the office/clinic.
Supervises nursing staff when appropriate, orients new staff.
Enhances professional growth and development through participation in educational programs, current literature, in-service meetings and workshops; shows responsibility for own professional practice and ongoing education.
Demonstrates an ability to be flexible, organized and function under stressful situations.
Demonstrates awareness of current state, federal and local laws governing the delivery of care.
Performs other duties as assigned or requested.
Demonstrates the ability to deal with pressure to meet deadlines, to be accurate, and to handle constantly changing situations.
Demonstrates the ability to deal with a variety of people, deal with stressful situations, and handle conflict.
Adheres to dress code.
Completes annual educational requirements.
Maintains regulatory requirements.
Wears identification while on duty.
Maintains confidentiality at all times.
Attends department staff meetings as required within the department.
Reports to work on time and as scheduled; completes work in designated time.
Represents the organization in a positive and professional manner.
Actively participates in performance improvement and continuous quality improvement (CQI) activities.
Coordinates efforts in meeting regulatory compliance, federal, state and local regulations and standards
Communicates and complies with the Benefis Health System Mission, Vision and Values as well as the focus statement of the department.
Complies with Benefis Health System Organization Policies and Procedures.
Complies with Health and Safety Standards and Guidelines.
Current LPN/CMA/RN license within the state of practice.
As a not-for-profit community health system, Benefis is driven to provide the highest level of care. We serve nearly 230,000 residents across a 15-county region that is bigger than Connecticut, Massachusetts, New Hampshire and Vermont combined. Benefis is the largest non-governmental employer in the Great Falls area, with more than 3,000 employees. Benefis has 530 licensed beds (that includes 146 beds in long-term care, 71 in assisted living and 20 beds at Peace Hospice of Montana) and partners with over 250 area physicians.
Our hospital has been recognized for its exceptional work in quality care by providing a wide range of programs and services to help you live the best life possible. We’re here to help you “Live well.”
Benefis Health System came about when two Christian-based hospitals became one. Our founders believed in providing good care to all in need, and trusted that this would be accomplished. The Benefis name was derived using Latin root words: "Bene-" meaning good, and "fis-" for faith and trust. It’s these same root words that make up such terms as ‘beneficial’ a...nd ‘confidence'. Benefis has been a trusted provider of care for more than 125 years. And our name speaks to our commitment: good care one can put faith in.
Benefis is consistently ranked among America’s top hospitals by the nation’s leading healthcare ratings organizations for a range of services, including cancer care, joint replacement, stroke treatment, wound care and home health.
To learn more about our services, continue looking through our website at WWW.BENEFIS.ORG or call 406.455.5000.