Job Category: Patient Services

Current Employees:

If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Primary Location

Rapid City, SD USA

Department

RCH Revenue Cycle Management Services

Scheduled Weekly Hours

40

Starting Pay Rate Range

$18.27 – $21.00

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

The Patient Services Specialist plays a vital role in ensuring timely and accurate patient access to medical services by managing the pre-arrival prior authorization services. This position enhances patient access to care by ensuring all scheduled medical service requests and referrals are financially cleared prior to the date of service provision through the performance of insurance eligibility validation, plan benefit verification, and any related financial clearance, prior authorization, and pre-determination processes.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions

*Flexible scheduling

Job Description

Universal Essential Functions:

• Collaborate with healthcare providers, clinical staff, and various departments throughout Monument Health as well as with the patient to secure necessary authorization for services while maintaining compliance with all regulatory requirements.
• Accurately verify patient insurance eligibility and benefits coverage, utilizing tools such as Electronic Health Records (EHR), add-on software, direct payer websites, and telephone or fax communications to ensure accurate reimbursement and compliance.
• Assess service requests to determine the need for pre-certification, pre-authorization (procedure or medication), or referrals, and communicate effectively with relevant stakeholders to secure approvals prior to the date of scheduled services.
• Maintain a strong working knowledge of various insurance payers, payer plans, and program contract requirements to facilitate appropriate insurance verification and authorization processes.
• Continuously meet competency requirements to sustain the necessary skills, knowledge, and abilities for role-specific functions, while adhering to productivity and quality performance standards.
• Create a positive service experience by being polite, compassionate, and professional with all internal and external customers.
• Document pre-authorization information accurately in the EHR system, ensuring that services scheduled by internal and external providers meet all financial clearance criteria and have approved authorization in the time allowed by the payers and programs to prevent denial or penalty assessment.
• Engage with departments and clinical staff to communicate the need for pre-authorizations or referrals promptly, working to prevent delays in patient care. May include requests for assistance with managing appeals as well as the facilitation and coordinating peer-to-peer reviews when needed.
• Identify high-risk requests that may require financial assistance and counseling and assist patients by providing guidance on available resources, financial assistance, or payment arrangements.
• Advocate for patients and providers by addressing challenges related to pre-authorization approvals and denials, working closely with leadership to resolve issues and ensure compliance with financial clearance policies.
• Provide backup support for Patient Admissions and Registration as needed
• All other duties as assigned.

Essential Functions for Medication Authorization and Assistant Specialist:

• Confirm prescription coverage and coordinate prior authorization, including collecting and submitting required clinical documentation (i.e. provider notes, labs and treatment history)
• Stay up to date on patient assistance programs and guide patients through required application documentation.
• Coordinate with providers and nursing staff to obtain required signatures and documentation from patients and providers
• Serve as a patient advocate by regularly communicating with pharmaceutical companies, providers and patients.
• Act as primary contact for patient inquiries about medication authorizations and assistance programs.
• Monitor assistance medications to ensure timely delivery and continuous patient access.
• All other duties as assigned.

Additional Requirements

Required:
Education – High School Diploma/GED Equivalent in General Studies

Preferred:
Experience – 1+ years in Health Care Services, Customer Service, Patient Scheduling, Patient Billing Experience
Education – Associates degree in Healthcare Related Field

Physical Requirements:
Sedentary work – Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.

Job Category

Patient Services

Job Family

Patient Support

Shift

Requires the ability to work assigned schedules and hours as determined by the department

Employee Type

Regular

10 Monument Health Rapid City Hospital, Inc.

Make a difference.  Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

Current Employees:

If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Primary Location

Rapid City, SD USA

Department

MHHVI Cardiac Services

Scheduled Weekly Hours

40

Starting Pay Rate Range

$18.27 – $21.00

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

The Patient Services Specialist plays a vital role in ensuring timely and accurate patient access to medical services by managing the prearrival prior authorization services. This position enhances patient access to care by ensuring all scheduled medical service requests and referrals are financially cleared prior to the date of service provision through the performance of insurance eligibility validation, plan benefit verification, and any related financial clearance, prior authorization, and pre-determination processes.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions

*Flexible scheduling

Job Description

Universal Essential Functions:

• Collaborate with healthcare providers, clinical staff, and various departments throughout Monument Health as well as with the patient to secure necessary authorization for services while maintaining compliance with all regulatory requirements.
• Accurately verify patient insurance eligibility and benefits coverage, utilizing tools such as Electronic Health Records (EHR), add-on software, direct payer websites, and telephone or fax communications to ensure accurate reimbursement and compliance.
• Assess service requests to determine the need for pre-certification, pre-authorization (procedure or medication), or referrals, and communicate effectively with relevant stakeholders to secure approvals prior to the date of scheduled services.
• Maintain a strong working knowledge of various insurance payers, payer plans, and program contract requirements to facilitate appropriate insurance verification and authorization processes.
• Continuously meet competency requirements to sustain the necessary skills, knowledge, and abilities for role-specific functions, while adhering to productivity and quality performance standards.
• Create a positive service experience by being polite, compassionate, and professional with all internal and external customers.
• Document pre-authorization information accurately in the EHR system, ensuring that services scheduled by internal and external providers meet all financial clearance criteria and have approved authorization in the time allowed by the payers and programs to prevent denial or penalty assessment.
• Engage with departments and clinical staff to communicate the need for pre-authorizations or referrals promptly, working to prevent delays in patient care. May include requests for assistance with managing appeals as well as the facilitation and coordinating peer-to-peer reviews when needed.
• Identify high-risk requests that may require financial assistance and counseling and assist patients by providing guidance on available resources, financial assistance, or payment arrangements.
• Advocate for patients and providers by addressing challenges related to pre-authorization approvals and denials, working closely with leadership to resolve issues and ensure compliance with financial clearance policies.
• Provide backup support for Patient Admissions and Registration as needed
• All other duties as assigned.

Essential Functions for Medication Authorization and Assistant Specialist:

• Confirm prescription coverage and coordinate prior authorization, including collecting and submitting required clinical documentation (i.e. provider notes, labs and treatment history)
• Stay up to date on patient assistance programs and guide patients through required application documentation.
• Coordinate with providers and nursing staff to obtain required signatures and documentation from patients and providers
• Serve as a patient advocate by regularly communicating with pharmaceutical companies, providers and patients.
• Act as primary contact for patient inquiries about medication authorizations and assistance programs.
• Monitor assistance medications to ensure timely delivery and continuous patient access.
• All other duties as assigned.

Additional Requirements

Required:
Education – High School Diploma/GED Equivalent in General Studies

Preferred:
Experience – 1+ years in Health Care Services, Customer Service, Patient Scheduling, Patient Billing Experience
Education – Associates degree in Healthcare Related Field

Physical Requirements:
Sedentary work – Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.

Job Category

Patient Services

Job Family

Patient Support

Shift

Requires the ability to work assigned schedules and hours as determined by the department

Employee Type

Regular

10 Monument Health Rapid City Hospital, Inc.

Make a difference.  Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

Current Employees:

If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Primary Location

Rapid City, SD USA

Department

MHOSH-Clinic Orthopedic Surgery

Scheduled Weekly Hours

40

Starting Pay Rate Range

$32.00 – $40.00

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

** $10,000 Sign On Bonus Available for Qualified Candidates **

The Orthopedic Care Navigator facilitates the care of the patients and the progress and organization of the Orthopedic Total Joint Program by coordinating the flow of the patients and progress of the department. Evaluation, comments and suggestions are used with the staff in order to promote an optimum level of patient care and staff development. Utilizes principles of the nursing process to organize and proved quality and continuity of nursing care in the department. The Orthopedic Care Navigator will be responsible for the development, management and coordination of all activities related to the Orthopedic Program with the main focus of creating the Joint Center of Excellence.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions

*Flexible scheduling

Job Description

Essential Functions:

• Conduct orthopedic educational programs and monitor effectiveness of such programs. Facilitate family involvement by supporting the “coach” role in the joint replacement process.
• Consistently keeps patient flow running smoothly. Demonstrates ability to make patient care decision based on the urgency of individual needs. Coordinate all patient processes and needs from the initial pre-op testing and patient registration to post op care. Serve as a liaison in the coordination of the patients preoperative care between physician's offices, the hospital and other facilities.
• Develop, implement and monitor the compliance with multidisciplinary orthopedic care pathways and revise based on patient satisfaction, standards of care and quality information.
• Anticipates the needs and wants of the provider by preparing the patient for surgery.
• Assess, set goals; prepares, implements, documents and adjusts the plan of treatment and education for each patient based on the patient's individual circumstances, medical condition and age, to meet the expectations of the patient, physician, and program.
• Market the orthopedic program through outreach community education, utilize “Graduates” as ambassadors, and provide evidence based patient feedback to the orthopedic surgeons and providers.
• Monitor joint replacement clinical outcomes and identify opportunities for improvement. Monitor growth of program as well as fiscal impact to the organization.
• Monitor patient satisfaction through patient satisfaction surveys and conduct in-house discharge phone calls to gather information regarding patient’s perceptions of care, patient outcomes and the joint replacement experience.
• Organize and lead the Orthopedic Program and the Joint Center of Excellence. Collaborate and coordinate with all disciplines regarding patient care. Receive information from multidisciplinary joint care team and drive solutions for identified problems.
• Consistently sets an example of excellence in clinical practice and professional behavior. Acts as a resource to clinical staff, patients, families and other customers regarding patient care. Mentors employees in the development and enhancement of clinical skills.
• All other duties as assigned.

Additional Requirements

Required:
Education – Completion of a nursing education program that is approved by a board of nursing
Certifications – Registered Nurse (RN) – South Dakota Board of Nursing

Preferred:

Education – Bachelors degree in Nursing

Experience – 1+ years of Case Management Experience; 1+ years of Patient Care Experience

Physical Requirements:
Light work – Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.

Job Category

Patient Services

Job Family

Care Coordination

Shift

Requires the ability to work assigned schedules and hours as determined by the department

Employee Type

Regular

70 Monument Health Orthopedic and Specialty Hospital

Make a difference.  Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

Current Employees:

If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Primary Location

Rapid City, SD USA

Department

CCI Administration

Scheduled Weekly Hours

36

Starting Pay Rate Range

$32.00 – $40.00

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

** $10,000 Sign On Bonus Available for Qualified Candidates **

The Patient Navigator navigates patients and family members through the diagnosis, treatment, and follow-up of the patient throughout an episode of care related to an identified organizational clinical service program (i.e. total joint replacement, identified care bundles, cancer treatment coordination, etc) to ensure smooth transitions between care settings. The Patient Navigator is responsible, along with the identified multidisciplinary care team, for the development, management and coordination of all activities related to the identified clinical service program. The Patient Navigator collaborates with the interdisciplinary teams in the management of education, bio-psychosocial and financial resources to achieve optimal outcomes for program patients. The Patient Navigator will work with identified patients throughout their episode of care until discharged from the program and transitioned to primary the care clinic team

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions

*Flexible scheduling

Job Description

Essential Functions:

• Acts as a resource to interdisciplinary team, patients and families throughout episode of care. Facilitates efficient, appropriate, seamless, coordinated care to help ensure positive patient outcomes.
• Supports patient and family by providing education, advocacy, addressing psychosocial needs, and identifying and addressing barriers to care.  Navigates patients and family throughout the diagnosis, treatment and follow-up through the episode of care
• Utilizes evaluative and outcomes data to facilitate the achievement of consistent clinical outcomes by concurrently assessing the quality of care provided based on predetermined indicators within the clinical service program and clinical judgement. Utilizes data and decisions to facilitate closure of healthcare gaps
• Organizes and completes a plan customized for each patient referred: scheduling, supportive resources and post-treatment resources through episode of care
• Participates with identified multidisciplinary team to discuss current and future patient cases and collaborative efforts to meet needs identified
• Assists with the evaluation, selection, and design of patient education materials for specific clinical programs.  Assists with providing education and outreach programs to patients, staff and community members
• Works with staff, administration and physicians to match resources with patient needs. Demonstrates effective fiscal management through cost containment measures while ensuring high quality, cost effective care is being provided to patients within clinical service program
• Assists leadership in the development of program goals and objectives.  Assists with the development, implementation, and maintenance of quality programs that include best practice patient care outcomes
• All other duties as assigned

Additional Requirements

Required:
Education – Completion of a nursing education program that is approved by a board of nursing
Certifications – Basic Life Support (BLS) Certification – American Heart Association (AHA) – Within 60 days of hire or transfer; Registered Nurse (RN) – South Dakota Board of Nursing

Preferred:

Education – Bachelors degree in Nursing

Experience – 1+ years of Case Management Experience; 1+ years of Patient Care Experience

Physical Requirements:
Light work – Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.

Job Category

Patient Services

Job Family

Care Coordination

Shift

Requires the ability to work assigned schedules and hours as determined by the department

Employee Type

Regular

10 Monument Health Rapid City Hospital, Inc.

Make a difference.  Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

Current Employees:

If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Primary Location

Rapid City, SD USA

Department

CCI Administration

Scheduled Weekly Hours

40

Starting Pay Rate Range

$32.00 – $40.00

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

** $10,000 Sign On Bonus Available for Qualified Candidates **

The Patient Navigator navigates patients and family members through the diagnosis, treatment, and follow-up of the patient throughout an episode of care related to an identified organizational clinical service program (i.e. total joint replacement, identified care bundles, cancer treatment coordination, etc) to ensure smooth transitions between care settings. The Patient Navigator is responsible, along with the identified multidisciplinary care team, for the development, management and coordination of all activities related to the identified clinical service program. The Patient Navigator collaborates with the interdisciplinary teams in the management of education, bio-psychosocial and financial resources to achieve optimal outcomes for program patients. The Patient Navigator will work with identified patients throughout their episode of care until discharged from the program and transitioned to primary the care clinic team

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions

*Flexible scheduling

Job Description

Essential Functions:

• Acts as a resource to interdisciplinary team, patients and families throughout episode of care. Facilitates efficient, appropriate, seamless, coordinated care to help ensure positive patient outcomes.
• Supports patient and family by providing education, advocacy, addressing psychosocial needs, and identifying and addressing barriers to care.  Navigates patients and family throughout the diagnosis, treatment and follow-up through the episode of care
• Utilizes evaluative and outcomes data to facilitate the achievement of consistent clinical outcomes by concurrently assessing the quality of care provided based on predetermined indicators within the clinical service program and clinical judgement. Utilizes data and decisions to facilitate closure of healthcare gaps
• Organizes and completes a plan customized for each patient referred: scheduling, supportive resources and post-treatment resources through episode of care
• Participates with identified multidisciplinary team to discuss current and future patient cases and collaborative efforts to meet needs identified
• Assists with the evaluation, selection, and design of patient education materials for specific clinical programs.  Assists with providing education and outreach programs to patients, staff and community members
• Works with staff, administration and physicians to match resources with patient needs. Demonstrates effective fiscal management through cost containment measures while ensuring high quality, cost effective care is being provided to patients within clinical service program
• Assists leadership in the development of program goals and objectives.  Assists with the development, implementation, and maintenance of quality programs that include best practice patient care outcomes
• All other duties as assigned

Additional Requirements

Required:
Education – Completion of a nursing education program that is approved by a board of nursing
Certifications – Basic Life Support (BLS) Certification – American Heart Association (AHA) – Within 60 days of hire or transfer; Registered Nurse (RN) – South Dakota Board of Nursing

Preferred:

Education – Bachelors degree in Nursing

Experience – 1+ years of Case Management Experience; 1+ years of Patient Care Experience

Physical Requirements:
Light work – Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.

Job Category

Patient Services

Job Family

Care Coordination

Shift

Requires the ability to work assigned schedules and hours as determined by the department

Employee Type

Regular

10 Monument Health Rapid City Hospital, Inc.

Make a difference.  Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

Current Employees:

If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Primary Location

Rapid City, SD USA

Department

CCI Administration

Scheduled Weekly Hours

40

Starting Pay Rate Range

$32.00 – $40.00

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

** $10,000 Sign On Bonus Available for Qualified Candidates **

The Patient Navigator navigates patients and family members through the diagnosis, treatment, and follow-up of the patient throughout an episode of care related to an identified organizational clinical service program (i.e. total joint replacement, identified care bundles, cancer treatment coordination, etc) to ensure smooth transitions between care settings. The Patient Navigator is responsible, along with the identified multidisciplinary care team, for the development, management and coordination of all activities related to the identified clinical service program. The Patient Navigator collaborates with the interdisciplinary teams in the management of education, bio-psychosocial and financial resources to achieve optimal outcomes for program patients. The Patient Navigator will work with identified patients throughout their episode of care until discharged from the program and transitioned to primary the care clinic team

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions

*Flexible scheduling

Job Description

Essential Functions:

• Acts as a resource to interdisciplinary team, patients and families throughout episode of care. Facilitates efficient, appropriate, seamless, coordinated care to help ensure positive patient outcomes.
• Supports patient and family by providing education, advocacy, addressing psychosocial needs, and identifying and addressing barriers to care.  Navigates patients and family throughout the diagnosis, treatment and follow-up through the episode of care
• Utilizes evaluative and outcomes data to facilitate the achievement of consistent clinical outcomes by concurrently assessing the quality of care provided based on predetermined indicators within the clinical service program and clinical judgement. Utilizes data and decisions to facilitate closure of healthcare gaps
• Organizes and completes a plan customized for each patient referred: scheduling, supportive resources and post-treatment resources through episode of care
• Participates with identified multidisciplinary team to discuss current and future patient cases and collaborative efforts to meet needs identified
• Assists with the evaluation, selection, and design of patient education materials for specific clinical programs.  Assists with providing education and outreach programs to patients, staff and community members
• Works with staff, administration and physicians to match resources with patient needs. Demonstrates effective fiscal management through cost containment measures while ensuring high quality, cost effective care is being provided to patients within clinical service program
• Assists leadership in the development of program goals and objectives.  Assists with the development, implementation, and maintenance of quality programs that include best practice patient care outcomes
• All other duties as assigned

Additional Requirements

Required:
Education – Completion of a nursing education program that is approved by a board of nursing
Certifications – Basic Life Support (BLS) Certification – American Heart Association (AHA) – Within 60 days of hire or transfer; Registered Nurse (RN) – South Dakota Board of Nursing

Preferred:

Education – Bachelors degree in Nursing

Experience – 1+ years of Case Management Experience; 1+ years of Patient Care Experience

Physical Requirements:
Light work – Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.

Job Category

Patient Services

Job Family

Care Coordination

Shift

Requires the ability to work assigned schedules and hours as determined by the department

Employee Type

Regular

10 Monument Health Rapid City Hospital, Inc.

Make a difference.  Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

Current Employees:

If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Primary Location

Rapid City, SD USA

Department

RCH Care Management

Scheduled Weekly Hours

40

Starting Pay Rate Range

$18.20 – $20.92

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

Supports the Case Management/Social Work functions related to payer pre-authorizations/notifications, utilization review submissions, education of patients and families regarding required regulatory notices, assists with patient discharge arrangements, specialized administrative assistance, record keeping and general care-coordination tasks as assigned by Case Management/Social Work partners.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions

*Flexible scheduling

Job Description

Essential Functions:

• Collaborates with the healthcare team, patients/families, payers, physician offices and other community agencies ensuring a team environment. Demonstrates excellent customer service skills in all interactions to provide a smooth and efficient department operation allowing for maximum comfort and confidentiality for the customer. Prioritizes workflow and knows when to ask for help.
• Verifies and obtains benefits levels from insurance carriers and employers when applicable and maintains appropriate and accurate documentation, both written and electronically. Maintains working knowledge of procedures and insurance requirements.
• Responsible to obtain the necessary knowledge and experience to perform job tasks in compliance with federal, state, and local laws, regulations and guidelines. Maintains compliance with all department policies and procedures. Completes Medicare Message follow up letter and Medicare Outpatient Observation Notices as identified by department process.
• Educates patients and families on coverage and coordination progress as directed by Case Management/ Utilization Management team.
• Coordinates, under direction of the nurse Case Manager/Social Worker and in collaboration with the healthcare team, patient care transitions which may include faxing information, arranging authorization and transportation, confirming arrangements, obtaining clothing, durable medical equipment etc.
• Supports comprehensive coordination of medical services including intake, screening and supporting the implementation of care plans to promote effective utilization of healthcare services.
• May assist in providing transportation as directed.
• Participate in staff meetings, training and/or in-services and on-going educational groups.
• Contributes to documentation of coordinated functions in appropriate computer systems and the patient’s electronic medical record.
• All other duties as assigned.

Additional Requirements

Required:

Education – High School Diploma/GED Equivalent in General Studies

Preferred:

Certification – Certified Nurse Aide (CNA) – South Dakota Board of Nursing

Experience – 1+ years of Clerical Experience; 1+ years of Medical Terminology Experience

Physical Requirements:
Sedentary work – Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.

Job Category

Patient Services

Job Family

Patient Support

Shift

Requires the ability to work assigned schedules and hours as determined by the department

Employee Type

Regular

10 Monument Health Rapid City Hospital, Inc.

Make a difference.  Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

Current Employees:

If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Primary Location

Rapid City, SD USA

Department

MHMC-RC Neurology and Rehab

Scheduled Weekly Hours

40

Starting Pay Rate Range

$18.27 – $21.00

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

The Patient Services Specialist plays a vital role in ensuring timely and accurate patient access to medical services by managing the prearrival prior authorization services. This position enhances patient access to care by ensuring all scheduled medical service requests and referrals are financially cleared prior to the date of service provision through the performance of insurance eligibility validation, plan benefit verification, and any related financial clearance, prior authorization, and pre-determination processes.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions

*Flexible scheduling

Job Description

Universal Essential Functions:

• Collaborate with healthcare providers, clinical staff, and various departments throughout Monument Health as well as with the patient to secure necessary authorization for services while maintaining compliance with all regulatory requirements.
• Accurately verify patient insurance eligibility and benefits coverage, utilizing tools such as Electronic Health Records (EHR), add-on software, direct payer websites, and telephone or fax communications to ensure accurate reimbursement and compliance.
• Assess service requests to determine the need for pre-certification, pre-authorization (procedure or medication), or referrals, and communicate effectively with relevant stakeholders to secure approvals prior to the date of scheduled services.
• Maintain a strong working knowledge of various insurance payers, payer plans, and program contract requirements to facilitate appropriate insurance verification and authorization processes.
• Continuously meet competency requirements to sustain the necessary skills, knowledge, and abilities for role-specific functions, while adhering to productivity and quality performance standards.
• Create a positive service experience by being polite, compassionate, and professional with all internal and external customers.
• Document pre-authorization information accurately in the EHR system, ensuring that services scheduled by internal and external providers meet all financial clearance criteria and have approved authorization in the time allowed by the payers and programs to prevent denial or penalty assessment.
• Engage with departments and clinical staff to communicate the need for pre-authorizations or referrals promptly, working to prevent delays in patient care. May include requests for assistance with managing appeals as well as the facilitation and coordinating peer-to-peer reviews when needed.
• Identify high-risk requests that may require financial assistance and counseling and assist patients by providing guidance on available resources, financial assistance, or payment arrangements.
• Advocate for patients and providers by addressing challenges related to pre-authorization approvals and denials, working closely with leadership to resolve issues and ensure compliance with financial clearance policies.
• Provide backup support for Patient Admissions and Registration as needed
• All other duties as assigned.

Essential Functions for Medication Authorization and Assistant Specialist:

• Confirm prescription coverage and coordinate prior authorization, including collecting and submitting required clinical documentation (i.e. provider notes, labs and treatment history)
• Stay up to date on patient assistance programs and guide patients through required application documentation.
• Coordinate with providers and nursing staff to obtain required signatures and documentation from patients and providers
• Serve as a patient advocate by regularly communicating with pharmaceutical companies, providers and patients.
• Act as primary contact for patient inquiries about medication authorizations and assistance programs.
• Monitor assistance medications to ensure timely delivery and continuous patient access.
• All other duties as assigned.

Additional Requirements

Required:
Education – High School Diploma/GED Equivalent in General Studies

Preferred:
Experience – 1+ years in Health Care Services, Customer Service, Patient Scheduling, Patient Billing Experience
Education – Associates degree in Healthcare Related Field

Physical Requirements:
Sedentary work – Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.

Job Category

Patient Services

Job Family

Patient Support

Shift

Requires the ability to work assigned schedules and hours as determined by the department

Employee Type

Regular

10 Monument Health Rapid City Hospital, Inc.

Make a difference.  Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

Current Employees:

If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Primary Location

Rapid City, SD USA

Department

Home Plus RC Home Care Services

Scheduled Weekly Hours

40

Starting Pay Rate Range

$16.74 – $20.92

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

The Customer Care Specialist is responsible for acting as a liaison between internal and external customers. Accurate maintains records and assures effective workflow. Communicates courteously, professionally and appropriately.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions

*Flexible scheduling

Job Description

Essential Functions

• Provides courteous, compassionate and respectful treatment of internal and external customers
• Greets all callers in a pleasant manner, effectively handling their needs.
• Complete and process documentation in an accurate and timely manner.
• Maintain a highly organized, efficient flow of information and be able to handle multiple tasks at a time.
• Assist in the smooth flow of information and maintain ongoing communication between customers and business.
• All other duties as assigned.

Additional Requirements

Required:
Education – High School Diploma/GED Equivalent in General Studies

Preferred:
Experience – 1+ years of Home Medical Equipment Experience or 1+ years of Home Care/Hospice Experience; 3+ years of Customer Service Experience; 1+ years Hospital Experience; 1+ years Clinical Experience

Physical Requirements:
Medium work – Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects.

Job Category

Patient Services

Job Family

Patient Support

Shift

Requires the ability to work assigned schedules and hours as determined by the department

Employee Type

Regular

40 Monument Health Home Plus

Make a difference.  Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

Current Employees:

If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Primary Location

Rapid City, SD USA

Department

Home Plus SP Home Care Services

Scheduled Weekly Hours

40

Starting Pay Rate Range

$16.74 – $20.92

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

The Customer Care Specialist is responsible for acting as a liaison between internal and external customers. Accurate maintains records and assures effective workflow. Communicates courteously, professionally and appropriately.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions

*Flexible scheduling

Job Description

Essential Functions

• Provides courteous, compassionate and respectful treatment of internal and external customers
• Greets all callers in a pleasant manner, effectively handling their needs.
• Complete and process documentation in an accurate and timely manner.
• Maintain a highly organized, efficient flow of information and be able to handle multiple tasks at a time.
• Assist in the smooth flow of information and maintain ongoing communication between customers and business.
• All other duties as assigned.

Additional Requirements

Required:
Education – High School Diploma/GED Equivalent in General Studies

Preferred:
Experience – 1+ years of Home Medical Equipment Experience or 1+ years of Home Care/Hospice Experience; 3+ years of Customer Service Experience; 1+ years Hospital Experience; 1+ years Clinical Experience

Physical Requirements:
Medium work – Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects.

Job Category

Patient Services

Job Family

Patient Support

Shift

Requires the ability to work assigned schedules and hours as determined by the department

Employee Type

Regular

40 Monument Health Home Plus

Make a difference.  Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.