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Responsibilities:

Manages client’s authorizations (units/sessions) for services and submits requests for initial and additional authorizations and communicates authorization information and requirements to the appropriate clinical and/or administrative staff.

Participates in and provides assistance with tracking data correlated with department quality performance.

Prepares and maintains appropriate records and/or documents and submits reports as required.

Provides assistance and coordination with other UR departments to maximize efficiency

Manages Failed Claims/Failed Activities and obtaining all insurance eligibilities daily.

Completes UR Admissions/Discharges in the electronic medical record

Assists with preparing documentation for appeals and hearings as needed.

Prepares and maintains appropriate records and/or documents and submits reports as required.

Reviews and certifies patient stays and need for any length of stay extensions in accordance with commercial insurance and governmental agency standards – Inpatient Programs.

Assists with obtaining initial Primary Care Physician Referrals as needed and obtains continuing Primary Care Physician Referrals – Inpatient and Sub-Acute Programs.

Performs other related duties as assigned.

Qualifications:

Bachelor’s Degree in Social Work or related field preferred; relevant work experience may be substituted for education

One-year admissions or UR experience, or related field; knowledge of length of stay guidelines is preferred.

Good writing skills, computer skills, and experience with Microsoft applications

Must be physically capable to receive verbal and written directions

Must be willing and able to work with all patients of Methodist Family Health, regardless of gender

Must have good auditory, visual and olfactory ability

Must be able to maintain effective audio, visual discrimination and perception needed for making observations, communicating with others, reading and writing, and operating office equipment and other treatment equipment

Must be able to use a telephone to communicate verbally and a computer to communicate through written means, to review information and enter/retrieve data, to see and read characters on a computer screen, chart or other treatment items

Requires the strength and stamina to perform clinical duties

Flu shot is mandatory and required for all positions (subject only to qualified exemptions).

COVID-19 vaccination and Flu vaccination are mandatory and required for all positions (subject to qualified exemptions).

Other: The individual employed in this position may accept other reasonable assignments, which may be necessary, for efficient operation of assigned programs as there is time and opportunity.

Job descriptions are not intended, nor should be construed, to be all-inclusive lists of all responsibilities, skills, efforts or working conditions associated with a job. While this job description is intended to be an accurate reflection of the job requirements, management reserves the right to modify, add or remove duties from particular jobs and to assign other duties as necessary.

When an employee performs two or more different jobs, for which different straight time hourly rates are established, the employee will be paid during overtime hours as a rate not less than one and one-half time the hourly rate established for the type of work, he or she is performing during the overtime hours.

Level One - Full Access

Ongoing regular access to PHI of all forms while the employee is on duty and performing within the scope of his or her job as defined by the employee's job description, and Policy and Procedure. 'Such access must be for cause, consistent with job responsibilities and related to patients, claims, audits, reviews and other legitimate business purposes.' (e.g. Physicians, nurses and other clinicians).

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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