Endocrinology

Cookeville Regional Medical Group

Scheduler, Referral, Pre-Certification LPN Apply
FT
8a-5p, M-F
Description:

Under the direction of the Site Manager, the Scheduler, Referral, Precertification Coordinator processes all requests received via fax, CPOE, and verifies member eligibility, including checking Practice Plus eligibility. Ascertains benefit availability and creates all events in Practice Partner EMR by responding to request per CRMG workflows. Is responsible for notifying requesting providers if the member has terminated coverage, any problems with referrals, or scheduling procedures or tests. Coordinates with the physician in the provision of care, out-patient services provided to minimize the process steps necessary for physician to achieve access for their patient. Assuring that the appropriate payers' have been identified and payers' requirements have been met. Prior authorizing by an insurance company approving the medical necessity of the procedure. Improve the relationship between the hospitals, physician by assuming this responsibility. Education of physician and team members about regulatory and process requirements.

 

1.  EDUCATION:  Graduate of a school of practical Nursing. Current Tennessee LPN License.

2.  EXPERIENCE:  Minimum twelve months experience working in a physician group practice in the pre-cert, referral or scheduling department.

3.  SKILLS:  Knowledge of general office machines, good computer skills. Comfortable using email and interacting with computer applications. Knowledge of practice management and word processing software. Ability to perform multiple and diverse tasks simultaneously. Must have a neat and professional appearance. Strong written and verbal communication skills and cheerful attitude. Able to enter data into the computer system accurately.  Adapt well to changing priorities.

 

Site Manager Apply
FT
8a-5p, M-F
Description:

This position is responsible for managing the physician practice to which assigned. Site Manager I will supervise 1-5 employees, Site Manager II will supervise 6-10 employees and Site Manager III will supervise 11 or more employees.

  

EDUCATION:   High school graduate. Some college level coursework preferred.

EXPERIENCE: At least 4 years of Medical Office experience in a clinic or group practice setting required. P&L and supervisory experience preferred.

SKILLS:  Must demonstrate a working knowledge of general medical terms/terminology and office procedures(both front office and clinical areas) as well as  typing skills, knowledge of medical office equipment and supplies; proficiency in the use of computers and various software applications with preference for electronic medical records. Must have a thorough working knowledge of all aspects of medical office operations including data and communication systems. Must possess a working knowledge of health insurance as it pertains to benefits, co-pays, deductibles, CPT and ICD coding requirements and network status as well as Medicare Part B/Physician Office billing, reimbursement and collection practices., Needs to be able to supervise by promoting sound business policies and procedures while complying with all organizational policies and procedures. Must demonstrate knowledge of cost containment strategies. Must be able to interact with people at a variety of levels via excellent verbal and written communications.