Serves as the central access point for referring providers and assists in meeting key service and financial pillar goals•Utilizes appropriate protocols and resources, critical thinking, and decision-making skills to navigate the patient through service lines to receive care for referred servicesCaptures patient level demographics, insurance eligibility, and registration details and authorizations prior to service completion•Tests and refines new technology and workflows within PAS to ensure strategic alignment across service lines and in support of the organization’s goals•Supports all aspects of patient coordination and barrier identification to support continuous growth in new patient external referrals and creating a competitive market for our patients and providersServes as the decision-making resource and utilizes critical thinking to analyze the needed coordination for patient care associated across multidisciplinary departments•Facilitates timely and efficient referrals and follow up with patients•Verifies insurance eligibility for all new patients entering VUMC through RMC via automated insurance plan eligibility databases•Coordinates with insurance entities to investigates, process, and log referral authorizations•Provides patient estimates based on coverage to support expectation of financial responsibilities•Conducts outreach efforts with referring providers to provide status updates•Completes documentation, including demographics and referral information notes and orders•Mentors and assists new and existing staff by educating others on area-specific knowledge, skills and tools, and departmental processes

Processing member claims and services

Runs and analyzes reports with the result of making recommendations for adjusting staffing levels to meet departmental productivity and profitability goals. Utilizing Avaya CMS,Microsoft and other tools.Organized weekly meetings between managers and workforce management to review weekly forecast and provide recommendations

This position facilitates the enrollment program and system wide practitioner enrollment for tCommunity Health Services (CHS) and serves as the primary enrollment liaison for clinics, payers, billing office, and practitioner related issues.

● Responsible for processing Workbook for Case Managers● Responsible for assisting and Mentoring New Hires with their job functions