Posting Description

We believe a career is more than just a career — it's a calling. Our teammates' "True North" is what calls them to health care; it’s their passion. At North Mississippi Health Services, we believe in helping you leverage and connect that passion with a much greater purpose that impacts people you know and love.

Recordkeeping/Documentation/Reporting

• Manage the reconsideration and clinical appeals processing of documents from IQH, HMS, and other 3rd party payers
• Documents and notifies insurance companies/3rd party payors of patient hospitalization to NMMC-Acute Care setting
• Coordinates the retrieval and submission of patient medical information for maximum reimbursement
• Records and communicates payor requests and authorizations
• Retrieves requested medical information and submits to insurance company/3rd party payor for post-acute care coordination (i.e. UM Reviews including clinicals, Discharge Plan)
• Maintains electronic Blue Cross/Blue Shield of Mississippi Census and other electronic census that may arise
• Generates and provides chart audit reports to appropriate personnel
• Reconciles discharge dispositions and other regulatory requirements as assigned
• Manages, documents, and tracks Medicaid TAN requests
• Electronic submission of Medicaid reviews for certification as required Clerical:
• Answers telephone calls, takes messages and responds to emails in a polite, professional manner Communication:
• Communicates effectively with staff, patients, family members, vendors and Management Customer Service:
• Provides accurate information and direction for patients, visitors, and staff; has a knowledge of hospital functions and resources
• Supports staff as needed Education:
• Maintain annual review requirements Regulatory Compliance:
• Adheres to NMHS/NMMC Policies/Procedures/Guidelines
• Complies with applicable Local/State/Federal policies/procedures/guideline/regulations/laws/statues