Demonstrates ability to accurately perform some or all of the following functions: determine appropriate clinical details to enter/extract data for scheduling, rescheduling, and/or cancelling exams. Entering patient and/or provider data into electronic medical system; maintain physician privilege list and/or payer requirements, etc.

Maintains and enhances an up-to-date level of knowledge regarding professional telephone nursing practices. Proactively provides service recovery as needed; utilizes message center to communicate and resolve scheduling issues with providers/patients.

Process incoming and outgoing patient and/or clinical staff calls for scheduling, rescheduling, cancellations, and/or conduct phone interviews for pre-procedure screening purposes, as a follow-up of patient discharge, and assessment of real or potential acute chronic health problems, utilizing customer-service-friendly skills and stellar phone etiquette.

Process verbal and written physician, department, and payer requests by obtaining clinical data for scheduling and certifying services; act as a liaison for provider/patient as necessary. As appropriate, maintains low abandonment rate and wait time based on call volume; provides timely follow-up as required; maintains established productivity standards.

Provides information to providers and/or patients regarding prescribed procedures, medications, and therapies, utilizing appropriate physician consultation; understands and explains medical terminology and procedures; identifies patient,family, physician, organization, and community resources for patients and physician consults and referrals.

Records, communicates, and documents data from phone calls to ensure a high quality of care, effective continuity of care, and prudent risk management for the organization.

Validates payer source, obtains pre-certification and/or prior authorization by obtaining clinical data and reviewing insurance eligibility criteria and/or Medicare guidelines, and, as necessary, recommends appropriate level of care.

May complete unit/department specific duties as outlined in department documents.

KNOWLEDGE, SKILLS, AND ABILITIES

Typing ability of 30 words per minute and competency in personal computer use.

Qualifications

Missouri Board of Nursing RN or Nurse Licensure Compact multi-state RN. When primary state of residency changes, compact state RNs must apply under new state of residency within thirty (30) days.

PREFERRED QUALIFICATIONS

Additional license/certification requirements as determined by the hiring department.

Equal Opportunity Employer At MU Health Care, an Equal Opportunity Employer, we are committed to building an inclusive environment based on mutual respect and learning. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex, pregnancy (including childbirth, lactation and related medical conditions), sexual orientation, gender identity, gender expression, age, disability, protected veteran status, or any other status protected by applicable state or federal law. At MU Health Care, we believe in the value of human diversity because it enriches our lives and our organization. We are committed to increasing access and inclusion as we continue to save and improve lives. If you have questions about this information, please contact Human Resources.