UNKNOWN

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Conducts psychiatric evaluations, follow-up assessments and participates in the clinical care and treatment planning process for SBH PHP/IOP patients including admissions and clinical team meetings. Skyway Behavioral Health is an innovative behavioral health center that goes beyond the treatment of psychiatric symptoms to address underlying biological, behavioral, and psychosocial causes of psychiatric disorders.

Skyway Behavioral Health is an innovative behavioral health center that goes beyond the treatment of psychiatric symptoms to address underlying biological, behavioral, and psychosocial causes of psychiatric disorders.  Our belief is that maladaptive coping strategies are adopted by patients for survival. While adaptive at one time or in specific ways, these coping strategies are now preventing patients from living the life they want to live.  Our treatments teach patients new skills that enable them to serve as their own behavioral therapists- thereby helping them to maintain recovery and generalize skills to their home environments.    At Skyway, we provide a fully immersive, intensive, whole-person experience that covers everything from neuroscience to nutrition.  We believe that the path to recovery from traumatic stress requires a focus that encompasses not just symptom management but also the treatment of underlying individual, systemic, developmental, and familial traumas. We use leading-edge, specialized, evidence-based treatment modalities to help our patients address the trauma and pain behind their behaviors and diagnoses – thereby empowering them to make lasting changes in their lives.    Our team has extensive clinical and leadership experience in the areas of traumatic stress, eating disorders, mood disorders, and personality disorders/pathology. At Skyway, we are committed to building a culture and team that cares for one another such that we may care for our families, communities, and clients.  At Skyway, we believe that recovery is not only possible but also attainable for all patients.    Role Description  The Medical Director is the primary physician responsible for clinical oversight of all medical aspects of the Skyway Behavioral Health (SBH) treatment program. He/she/they are responsible for ensuring the quality, safety, and efficacy of the SBH treatment model, and providing medical supervision for the organization’s medical and non-therapeutic medical staff i.e., nursing/CNAs. This position will also fully participate in admission and clinical meetings including DBT team meetings and team rounds, clinical staffing, and leadership meetings.  The medical director's job duties are divided between direct clinical care for the patients and administrative and leadership-related tasks i.e., supervision and meetings. Skyway aims to offer an individualized, multidisciplinary treatment team approach wherein the Medical Director will work with staff within many disciplines including therapy, nursing, dietary, dietetics, and administrative professionals.    Essential Functions/Core Responsibilities  • Provides medical supervision and administrative direction to SBH privileged and credentialed medical staff for PHP/IOP and neuromodulation program.• Facilitates the creation and approval of medical policies and procedures.• Conducts psychiatric evaluations, follow-up assessments and participates in the clinical care and treatment planning process for SBH PHP/IOP patients including admissions and clinical team meetings.• Provides initial assessments and follow-up assessments for patients in neuromodulation program.• Provides confirmation of psychiatric diagnosis and prescribes medical and psychiatric treatment; supervises and directs the psychiatric and, at times, medical aspects of treatment.• Participates in the implementation of SBH’s quality assurance plan; assuring that psychiatric care meets quality assurance standards.• Occasionally provides night, weekend, and holiday medical triage and treatment authorizations via telephone; prescribe medications; provides medical supervision to mid-level practitioners. • Acts as a physician  leader of a multi-disciplinary patient care team for PHP and neuromodulation program patients.• Confers with clinical staff and patients and their families regarding diagnosis and treatment; makes referrals to specialists as appropriate. • Provides clinical assessments and crisis intervention for psychiatric emergencies.• Serves as point of contact for administrative concerns of support staff for neuromodulation program.• Assures compliance with Spravato (esketamine) REMS program.• Assists in developing any new workflows for neuromodulation program treatment(s).• Assures that patient medical records are accurate, meet legal and medical requirements, and are completed in a timely manner. • Maintains relationships with community physicians and other health care professionals who are important referral sources for SBH.• Establishes and maintains effective communications and working relationships with physicians, providers, and all colleagues.  • Assists in clinical education of APPs within organization.• Engage with marketing/outreach efforts with referral resources and potential partners.• Collaborates with the leadership team in creating and sustaining a culture of compassion and healing.  • Promotes the Skyway culture by demonstrating genuine concern and compassion for all staff such that they may do the same for one another and our communities, patients, and customers.  • Supports the organization's mission, vision, values, and strategic initiatives. Develops, implements, and improves processes to ensure that established policies, goals, and objectives are achieved.   • Maintains in good standing medical license, board status and credentialing.• Oversees peer review process for credentialed medical staff.  What are we looking for?  • Licensed in the state of Illinois as a physician, with a board certification in adult psychiatry. • Must be free of any investigations or sanctions by local and/or federal regulatory agencies. • Minimum of 2 years of experience in an outpatient or higher level of care in a mental health setting. • Effective interpersonal, oral, and written communication abilities.• Outstanding presentation skills for marketing and training opportunities.• Proficient with computers, web-based programs, and an electronic medical record system.   • Ability to work independently as needed yet recognize the need for support and demonstrate the willingness to ask for help. • Ability to manage multiple priorities, respond with confidence, and resolve during challenging or chaotic situations.   • Excellent interpersonal skills. Must be fluent in reading, writing, and speaking English. • Someone who embodies Skyway values:  o We embrace the whole person.  o We commit to innovative research-backed programs.  o We are better together.  o We celebrate all expressions of diversity.  o We believe in service and supporting our communities.  Physical Demands  The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee frequently is required to stand; use hands to finger, handle, or feel; reach with hands and arms; stoop, kneel, crouch, or crawl; and taste or smell. The employee is occasionally required to walk and climb or balance. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.  Benefits:• Medical benefits- Blue Cross Blue Shield of Illinois• Dental benefits- Blue Cross Blue Shield of Illinois• Vision benefits- Blue Cross Blue Shield of Illinois• Short & Long Term Disability- Blue Cross Blue Shield of Illinois• 401K Safe Harbor Match- Ameritas BlueStar • PTO• Paid Sick Time• Paid Holidays• Paid Floating Holidays• Paid Wellness Days• Regular clinical supervision• Collaborative professional growth development Work Environment  The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is occasionally exposed to wet and/or humid conditions and outside weather conditions. The noise level in the work environment is usually moderate.  Skyway Behavioral Health is proud to be an Equal Opportunity Employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.    We celebrate diversity and are committed to creating an inclusive environment for all employees.

Skyway Behavioral Health

Medical Director - Behavioral Health

HiringThing

OTHER

Work with patients to formulate an individualized plan to obtain medication, particularly, in light of Medicare coverage limitations including the facilitation of enrollment in various drug companies’ patient assistance programs when warranted. • Assist the team with care delivery by scheduling appointments, arranging interpreters, assisting with the completion of forms, ensuring that patients can access services, and arranging transportation to and from medical appointments as needed.

HOUR

Min:
USD $29.44/Hr.

Max:
USD $45.64/Hr.

Overview:
Join Memorial Health and make a real difference in the lives of patients and their families. As a PRN Counselor (LSW) with an MSW degree, you'll play a critical role in addressing complex psychosocial factors that affect health outcomes, contributing to holistic, patient-centered care. Key Responsibilities: • Conduct comprehensive biopsychosocial assessments to inform healthcare decisions. • Address social determinants of health to prevent readmissions and adverse outcomes. • Develop interventions that consider the full psychosocial impact of illness or hospitalization. • Collaborate with the healthcare team to remove barriers to post-acute care. • Facilitate timely referrals to community resources and promote patient self-reliance. • Prevent unnecessary hospital admissions by addressing social needs and avoiding "social admissions." Bring your LSW license and MSW degree to a dynamic team and help improve patient outcomes through compassionate, proactive care. Shift: PRN on call, Could be called in any day Mon – Fri 7:30am – 4pmHighlights & Benefits:Paid Time Off (PTO)Employee Assistance Program and Colleague Wellness<a class="fui-Link ___1q1shib f2hkw1w f3rmtva f1ewtqcl fyind8e f1k6fduh f1w7gpdv fk6fouc fjoy568 figsok6 f1s184ao f1mk8lai fnbmjn9 f1o700av f13mvf36 f1cmlufx f9n3di6 f1ids18y f1tx3yz7 f1deo86v f1eh06m1 f1iescvh fhgqx19 f1olyrje f1p93eir f1nev41a f1h8hb77 f1lqvz6u f10aw75t fsle3fq f17ae5zn" href="https://jobs.memorial.health/about/benefits/" rel="noopener nofollow noreferrer" target="_blank" title="https://jobs.memorial.health/about/benefits/">Benefits - Memorial HR</a> 

Qualifications:
 Education: • Master’s degree of Social Work from a School of Social Work accredited by the Council on Social Work Education. Licensure/Certification/Registry: • Illinois Licensed Social Worker required within six months of hire date Experience: • Experience working with adults across the life span presenting with chronic or serious illness • Experience identifying and coordinating the needs of chronically ill patients and families as well as supporting the care team • Understanding of psychosocial implications of illness, hospice and/or home care death and dying issues. • Knowledge of local community resources. • Knowledge and understanding of individual development and human behavior as it relates to the effects of illness and of the influence of culture on healthcare 

Responsibilities:
 Biopsychosocial Assessment • Utilizing specialized knowledge and experience, make assessment of patients’ psychosocial needs, home situation and economic constraints • Psychiatry assessments must be completed within 3 working days of patient’s admission and include regulatory mandated information.Community Resources • Serve as liaison between patients/ families and community agencies • Coordinate information and referrals for financial and community resources to link patients/families to the appropriate resources. • Serve as resource to clinical team, patients and families regarding entitlement to programs and support services • Develop strong working relationships with internal and external healthcare organizations and community resources. • Work with patients to formulate an individualized plan to obtain medication, particularly, in light of Medicare coverage limitations including the facilitation of enrollment in various drug companies’ patient assistance programs when warrantedCare Delivery • Work closely and collaboratively with the clinical care team across sites of care • Assist the team with care delivery by scheduling appointments, arranging interpreters, assisting with the completion of forms, ensuring that patients can access services, and arranging transportation to and from medical appointments as needed • Participate in clinic office visits, team rounds, or family conferences with when needed based on site of careCare Transitions • Coordinate patient care with other disciplines involved in the plan of care and maintain appropriate documentation • Confer with the patient, family, and clinical team to obtain information to coordinate efficient and quality patient care. • Build relationships with primary care providers, skilled nursing facilities, and the community to promote continuity of careEmbody the Memorial Health Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values: Support • Provide crisis intervention and supportive counseling for patients and their families as needed • Serve as patient advocate, assisting with navigation of patient eligible resources and programs • Provide patients and families with support and information to overcome personal and environmental difficulties which pre-dispose toward illness or interfere with obtaining maximum benefits from medical care • Assist patients to effectively utilize available resources to meet their personal health needs and help them develop their own capabilities • Evaluate patients’ ability to independently manage self and locate alternative resources when limitations are identified Advance Care Planning • Maintains a working knowledge of relevant medical/legal issues that impact patient care, e.g., advance directives, power of attorney, and guardianships.Counseling • When requested, provide group, individual, and family counseling to patients and their families as requestedDischarge Planning • Initiate discharge planning when patient is admitted. • Assure that discharge plans are secured when patient is medically ready for discharge • Assure that all necessary information has been transmitted to next provider of care.Record documentation for all social work activities in the electronic medical record in a timely and thorough manner. • Psychiatry colleagues must document in record after each session and supports information needed for Utilization Review criteria and the patient treatment plan.Adhere to department productivity standards.Participate in the monitoring of quality and utilization metrics and participates in improvement efforts to refine the delivery of care to maximize clinical, quality, and fiscal outcomes.Assists, as needed, in the staff training, new employee orientation, student education, community education, in-house activities, and general public relations activities.Refer to ancillary teams when warranted.Aware of and comply with department and hospital policy and procedures.Demonstrates knowledge of care for older adults through accurate assessments, treatment and effective implementation of interventions.Adhere to the NASW Code of Ethics.Comply with the Illinois Mental Health Code and Confidentiality Act.Participate in continuing education and in-service training to support professional growth and expertise.Perform other related duties as assigned. The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job. Incumbents may be requested to perform tasks other than those specifically presented in this description.

Memorial Health

LSW Counselor - PRN

[AW]-iCims

This is a high-impact, externally facing role that is ideal for a creative and globally minded professional who excels in communication, strategic thinking, and relationship development with high school students, parents, counselors, and educational partners. Qualifications: To thrive in this role, you should possess the following qualifications: 3+ years of relevant experience in recruitment, admissions, marketing, or youth education; experience working with high school students, parents, or counselors is strongly preferred.

Overview:
<div class="ewa-rteLine">Are you interested in joining a dynamic and international team of professionals to transform education? IE University's Global Markets is looking for an Associate Director, UG Texas to join its team!</div><div class="ewa-rteLine"> </div><div class="ewa-rteLine">This is a high-impact, externally facing role that is ideal for a creative and globally minded professional who excels in communication, strategic thinking, and relationship development with high school students, parents, counselors, and educational partners.  </div><div class="ewa-rteLine"> </div>Why IE University?Every story begins with a purpose, and ours has always been about people. Founded in 1973, IE University has continuously raised the bar to drive positive change through education. We believe education is more than a path to professional success; it is a catalyst for personal transformation and meaningful impact.  At IE University, we place people and their potential at the center of everything we do, empowering individuals to become extraordinary. We encourage bold thinking and foster a culture where innovation, curiosity, and courage lead to real-world impact. Together, we create an environment where talent thrives, and ideas shape the future.  Our mission We support students in developing impact skills to live and lead with positive impact. This ignites a ripple effect: We transform people, who then transform others, systems, society, and, ultimately, our world.   Our PurposeTo foster positive change.   Values  <ol><li style="text-align:justify">Cultivate the humanistic approach.  </li><li style="text-align:justify">Empower your entrepreneurial spirit </li><li style="text-align:justify">Cherish the diversity of people, mind, and experience </li><li style="text-align:justify">Drive innovation with a proactive mindset</li></ol><div class="ewa-rteLine">We are looking for a person to join a full-time position in  Austin, Texas, USA.</div><div class="ewa-rteLine"> </div>

Responsibilities:
<div class="ewa-rteLine">Your role as Associate Director will involve:</div> As Associate Director, Undergraduate Programs – Texas/Midwest US, you will manage recruitment and outreach across Texas (TX), Arizona (AZ), Colorado (CO), New Mexico (NM), Utah (UT), and Wyoming (WY). In this role, you will: <ul><li> Design and execute recruitment strategies to increase visibility and enrollment in IE University’s undergraduate programs throughout the assigned territory.  </li><li> Develop and nurture relationships with multiple stakeholders, including high school counselors, educational consultants, international schools, and community-based organizations. </li><li> Guide prospective students and families through the admissions process with personalized support, one-on-one consultations, and informational sessions. </li><li> Lead high-impact outreach activities, including high school visits, education fairs, Open Days, and IE master classes—both virtually and in-person. </li><li> Represent IE University at regional and national conferences for students, high school counselors and global education networks. </li><li> Collaborate cross-functionally with global teams across marketing, admissions, and alumni to deliver an engaging and consistent student experience. </li><li> Use data and CRM tools to track outreach, analyze recruitment performance, and continuously refine engagement strategies. </li><li> Contribute to content and communications geared toward U.S. high school students and their families, working closely with the global marketing team.</li></ul>

Qualifications:
<div class="ewa-rteLine">To thrive in this role, you should possess the following qualifications:</div><ul><li> 3+ years of relevant experience in recruitment, admissions, marketing, or youth education; experience working with high school students, parents, or counselors is strongly preferred.</li><li> Outstanding interpersonal and communication skills and comfortable presenting to diverse audiences both in person and virtually. </li><li> Strategic thinking and creativity in driving growth, engagement, and awareness.</li><li> Ability to work independently while collaborating with global stakeholders.</li><li> Passion for international education and cultural exchange.</li><li> Spanish language skills are a plus, but not mandatory.</li><li> Willingness to travel regionally and occasionally travel internationally. </li><li> Bachelor's degree required; Master’s preferred. </li></ul> What We Offer Salary Range: $70,000- 75,000+ 25% Bonus based on objectives Additional Benefits: <ul><li>Health, dental, and vision insurance: Health plan executed with United Healthcare (Eligible after the first month of employment) </li><li>Paid vacation and personal days: 15 Days per year + All Federal Holidays + 2 Personal Days+ 5 sick days </li><li>401(k) retirement plan eligibility through ADP (No Matching Program) </li><li>Annual Company-Wide Retreat in Madrid </li><li>Summer Fridays  </li><li>Work Culture: Flexible, international, impact-focused </li></ul>Schedule & Location <ul><li> Full-time</li><li> Monday and Friday (Hybrid schedule). Some weekends are required. </li><li> Based in our Austin office (in office three days a week), Tuesday, Wednesday, and Thursday in person </li></ul><div class="ewa-rteLine">Unleash your full potential and make an impact. The next move is yours! </div><div class="ewa-rteLine"> </div><div class="ewa-rteLine">If you want to be part of this educational revolution, we invite you to apply to join our dynamic team at IE University. </div><div class="ewa-rteLine"> </div><div class="ewa-rteLine">At IE University, we actively promote equal opportunities in recruitment and access to employment, ensuring the absence of gender, sexual orientation, religion, age, ethnic origin, or disability bias throughout the selection process.</div>

IE University

Associate Director, UG Texas, Global Markets

Overview: The Insurance Pre-Authorization Specialist I is responsible for completing prior authorizations, pre-certifications, and notifications for third-party and government payers across all pre-scheduled elective inpatient admissions, direct admits, emergency room admissions, and outpatient procedures. Identifies, reviews, and processes pre-authorizations, pre-certifications, and notifications for Medicare, Medicaid, commercial, and managed care payers for inpatient, outpatient, emergency, and elective services.

Min:
USD $16.50/Hr.

Max:
USD $24.82/Hr.

Overview:
The Insurance Pre-Authorization Specialist I is responsible for completing prior authorizations, pre-certifications, and notifications for third-party and government payers across all pre-scheduled elective inpatient admissions, direct admits, emergency room admissions, and outpatient procedures. This role requires a thorough working knowledge of insurance plans and benefit structures to obtain detailed benefit information and maximize plan utilization.The specialist coordinates with third-party payers, physicians, nursing staff, and other healthcare providers to ensure all prior authorization and pre-certification requirements are met in accordance with payer guidelines. This includes providing education and direction to clinical and administrative staff regarding authorization processes and payer-specific requirements to support accurate and timely reimbursement.This position is responsible for tracking, documenting, and monitoring authorization and pre-certification status throughout the continuum of care. The specialist also performs dynamic coding for outpatient services and urgent admissions by correlating and documenting accurate procedural and diagnosis codes based on physician orders.In addition, the role includes communicating delays, denials, or issues related to authorization determinations to clinical staff across service lines as well as to Managed Care, Utilization Management, and Patient Financial Services teams. When appropriate, the specialist may provide guidance to patients regarding appeal procedures for denied authorizations.A strong understanding of insurance and payer policy language is essential, including knowledge of benefits and authorization requirements at admission, during the hospital stay, and at discharge. This includes supporting concurrent review processes while patients are actively receiving care. To review Memorial's Benefits click here: <a href="https://jobs.memorial.health/about/benefits/" rel="noopener nofollow noreferrer" target="_blank">Benefits - Memorial HR</a>

Qualifications:
<h2>Education</h2><ul><li>High school diploma or equivalent required.</li></ul><hr/><h2>Experience</h2><ul><li>Minimum of three (3) years of healthcare registration, billing/claims, scheduling, or physician office experience required.</li><li>Experience with or working knowledge of call center processes preferred.</li></ul><hr/><h2>Knowledge, Skills, and Abilities</h2><h3>Healthcare & Billing Knowledge</h3><ul><li>Demonstrated working knowledge of medical terminology, procedural and diagnosis coding, and hospital billing workflows and processes required.</li><li>Awareness and understanding of healthcare industry trends and developments, including Health Care Reform, required.</li></ul><h3>Technical Skills</h3><ul><li>Proficiency with Microsoft Office Suite (Outlook, Excel, Word) required.</li><li>Ability to navigate multiple systems and applications, including:<ul><li>Online learning platforms for job competencies</li><li>Electronic registration and billing systems</li><li>Online forms, policies, and benefits enrollment tools</li></ul></li></ul><h3>Communication & Interpersonal Skills</h3><ul><li>Ability to communicate clearly and effectively, both verbally and in writing, with:<ul><li>Patients and families</li><li>Physicians and clinical staff</li><li>Payers and insurance representatives</li><li>Internal departments and leadership</li></ul></li><li>Ability to educate, persuade, and negotiate with patients/families to ensure compliance with payer requirements and collections goals.</li></ul><h3>Critical Thinking & Problem Solving</h3><ul><li>Ability to analyze information, problems, and workflows to identify:<ul><li>Patterns and trends</li><li>Cause-and-effect relationships</li><li>Logical conclusions and alternatives</li></ul></li><li>Ability to develop practical, comprehensive solutions.</li></ul><h3>Work Performance & Adaptability</h3><ul><li>Ability to remain flexible and exercise sound judgment in high-stress situations.</li><li>Capable of managing competing priorities and working independently with minimal supervision.</li><li>Demonstrated initiative and reliability in completing assignments.</li><li>Ability to adapt to changing operational needs, including staffing shortages, cross-training requirements, and departmental coverage needs.</li><li>Willingness to provide coverage and complete assignments prior to end of shift when necessary.</li></ul><h3>Productivity Expectations</h3><ul><li>Ability to process an average of 40–45 scheduled patient accounts/visits per day.</li></ul>

Responsibilities:
<h3>Insurance Verification, Authorization & Eligibility</h3><ul><li>Identifies, reviews, and processes pre-authorizations, pre-certifications, and notifications for Medicare, Medicaid, commercial, and managed care payers for inpatient, outpatient, emergency, and elective services.</li><li>Ensures patient eligibility requirements are met prior to service delivery.</li><li>Utilizes payer portals, internal systems, and direct communication with physician offices and third-party payers to obtain authorization and benefit information.</li><li>Analyzes patient eligibility, benefits, and reason-for-visit criteria to confirm documentation completeness and payer compliance prior to admission.</li><li>Coordinates primary, secondary, and tertiary coverage to ensure correct coordination of benefits and reduce duplicate payments or claim errors.</li></ul><hr/><h3>Medical Coding & Clinical Documentation Support</h3><ul><li>Interprets patient requisitions and assigns accurate ICD-10-CM and CPT codes in alignment with coding guidelines.</li><li>Ensures correct diagnosis and procedure code sequencing based on patient signs, symptoms, and clinical documentation.</li><li>Collaborates with HIM coding staff, physicians, and clinical teams to validate coding accuracy and resolve discrepancies.</li><li>Maintains compliance with outpatient coding standards, reimbursement rules, and regulatory requirements.</li></ul><hr/><h3>Compliance, Regulatory, and Payer Knowledge</h3><ul><li>Maintains up-to-date knowledge of CMS, JCAHO, FI, Medicare, Medicaid, and commercial payer requirements.</li><li>Participates in continuing education and compliance training related to medical terminology, anatomy, physiology, disease processes, and surgical procedures.</li><li>Maintains and updates payer reference materials, including authorization requirements and coverage changes.</li><li>Ensures compliance with HIPAA, Illinois Fair Patient Billing Act, Illinois Uninsured Patient Discount Act, and hospital policies.</li></ul><hr/><h3>Revenue Cycle & Financial Clearance</h3><ul><li>Verifies insurance benefits and communicates coverage, authorization requirements, and self-pay responsibilities to patients and families.</li><li>Identifies and resolves issues that may lead to claim denials, retrospective medical necessity reviews, or benefit reductions.</li><li>Contacts payers and patients to facilitate timely reimbursement and resolve billing issues.</li><li>Supports point-of-service collections by collecting co-pays, deposits, and patient financial responsibility using electronic payment systems.</li><li>Reviews rejected or unresolved accounts and works toward resolution through eligibility verification or financial assistance determination.</li></ul><hr/><h3>Systems, Documentation & Workflow Management</h3><ul><li>Maintains accurate documentation of authorization status, benefit verification, and payer communications in hospital billing systems (e.g., Cerner).</li><li>Independently tracks authorization requests and outcomes through completion.</li><li>Utilizes payer websites and internal tools to ensure accurate and timely submission of authorization requests.</li><li>Ensures all pre-certification documentation is completed prior to patient arrival to minimize delays and financial risk.</li></ul><hr/><h3>Interdepartmental Coordination & Communication</h3><ul><li>Coordinates with Patient Financial Services, Managed Care, Case Management, Scheduling, Clinical departments, and Social Services to ensure consistent documentation and workflow alignment.</li><li>Provides administrative and operational support to clinical and medical management teams, including concurrent review functions.</li><li>Communicates authorization issues or payer delays to appropriate stakeholders to ensure timely resolution.</li></ul><hr/><h3>Patient Financial Assistance & Education</h3><ul><li>Educates patients on insurance coverage, advance directives, Medicare Part D, and grievance processes.</li><li>Refers patients to Medicaid vendors or financial assistance programs when appropriate.</li><li>Applies knowledge of regulatory billing protections and uninsured patient discount programs.</li></ul><hr/><h3>Performance, Productivity & Operational Standards</h3><ul><li>Meets productivity standards (approximately 40–45 encounters processed daily).</li><li>Maintains accuracy, efficiency, quality, patient satisfaction, and attendance benchmarks.</li><li>Meets or exceeds point-of-service collection goals and revenue cycle performance metrics.</li><li>Participates in cross-training, mentoring, and onboarding of new staff.</li><li>Supports leadership with special projects, workflow improvements, and departmental initiatives.</li><li>Demonstrates flexibility to work additional hours, nights, weekends, or shift coverage as needed.</li></ul><hr/><h3>Professionalism & Compliance</h3><ul><li>Maintains superior patient relations using tact, professionalism, and sound judgment.</li><li>Adheres to all HIPAA, Joint Commission, CDC, and organizational compliance standards.</li><li>Completes required certifications and ongoing revenue cycle education.</li><li>Participates in mandatory meetings and contributes to continuous improvement initiatives.</li></ul>

Insurance Pre-Auth Spec I

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Medical Director - Behavioral HealthSkyway Behavioral Health

LSW Counselor - PRNMemorial Health

Associate Director, UG Texas, Global MarketsIE University

Insurance Pre-Auth Spec IMemorial Health

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