MV INFUSION - RESOURCE SPECIALIST

Mountain View Hospital is looking for a Resource Specialist to join our team! 

Job Summary:  This position is responsible for training and filling in for the office staff at Mountain View Infusion and Prescription Center Homecare Infusion. Services provided by this position include, but are not limited to: scheduling, prior authorization, admissions, clerical, billing, audits, and inventory management.

About Mountain View: 

Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting-edge care to our patients. We serve the entire Snake River Valley – all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice. 

Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply. 

Duties and Responsibilities: 

1. Collaborates with other members of the healthcare team to help provide positive patient care. Assists pharmacists, physicians, nurses, and staff as needed. Works closely with referring offices to be used as a resource in helping them get necessary paperwork to start pre-authorizations, prove medical necessity, or to perform a retro-authorization.
2. Ensures information entered into the system is accurate. Checks appointments and tasks/messages to make sure the diagnosis/documentation will support medical necessity, as per insurance company, and verify that all visits and procedures that need preauthorization are pre-authorized. Follow and verify all authorizations for recurring infusions/therapies. Secures physician orders and uses all patient information for charting, billing and record keeping purposes.
3. Accountable for the performance of clerical functions to support smooth administrative operations of the organization including: Performs typing, filing, copying, mailing, phone reception, or other clerical functions, and runs errands as directed, May unpack supplies and stock inventory, if assigned.
4. Accurately, and in a timely manner, processes requests for office visits and procedures to be sent from other facilities and physician’s offices.
5. Verifies all patients have appropriate diagnosis for each therapy to support medical necessity according to LCD’s and payer policies, when submitting prior authorization requests.
6. Works closely and professionally with referring providers when infusion/therapy authorization needs to be done and/or is denied reimbursement to help the provider get all paperwork in order to start the authorization process, prove medical necessity, and/or retro-authorization.
7. Works directly with Billing Office in denials. Responsible for authorization follow-up for new and recurring infusions and therapies.
8. Works to provide functional and safe surroundings for patients and staff (i.e., safety, security, infection control, etc.). Strives to always promote personal and patient safety. Demonstrates awareness of the location of applicable hospital and department specific manuals.

BENEFITS: 

Taking care of our community starts with taking care of our own team. Mountain View Hospital is proud to offer its employees competitive and comprehensive benefit packages. Benefits include: 

• Medical, Dental and Vision Insurance 

• Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off 

• Retirement Plans (401K with up to 6% match) 

• Earned Quarterly Bonus Program 

• Education Reimbursement Program 

• Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital 

Please note benefits are based on eligibility according to full-time, part-time or PRN status classification. 

Education/Certifications:  High School graduate or equivalent. Knowledge of diagnoses and CPT codes for authorizing infusion services preferred.

Experience:  Prior experience with coding and billing for outpatient billing is preferred.