Healthcare Specialist Job Description
Healthcare Specialist Duties & Responsibilities
To write an effective healthcare specialist job description, begin by listing detailed duties, responsibilities and expectations. We have included healthcare specialist job description templates that you can modify and use.
Sample responsibilities for this position include:
Healthcare Specialist Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Healthcare Specialist
List any licenses or certifications required by the position: HCCA
Education for Healthcare Specialist
Typically a job would require a certain level of education.
Employers hiring for the healthcare specialist job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Medical, Education, Business, Healthcare, Associates, Business/Administration, Communication, Marketing, Science, Computer Science
Skills for Healthcare Specialist
Desired skills for healthcare specialist include:
Desired experience for healthcare specialist includes:
Healthcare Specialist Examples
Healthcare Specialist Job Description
- Handle telephone calls to patient, surgeon, or facility to verify insurance information
- Communicate payer infrmation effectively to appropriate parties and departments
- Resolve problems that may arise whether internal or external with the utmost professionalism
- Provides follow up and ongoing training for IWSS service specifics for hospital staff and employees
- Looks for new opportunities to reduce cost and improve performance
- In partnership with the Integrated Waste Compliance Specialist, train hospital personnel on the regulatory requirements of the waste streams being managed
- Proactively looks for new ways or services to increase the profitability of the program
- On an ongoing basis, provides the customer quick resolution and follow-up on all projects and issues
- Research, analyze, present results, and recommend intelligent solutions to solve problems and address business challenges by applying a knowledge of healthcare claims analysis, critical-thinking skills, and healthcare experience/expertise
- Determining credibility and usability of claims data prior to delivery of analytic results
- Demonstrates knowledge of Microsoft Office Products
- Demonstrates knowledge of all hospital related waste streams
- Hazardous Materials and OSHA Regulations
- 2-4 years experience in insurance verification or patient registration
- Prior authorization/precertification experience prefered
- Previous experience with out of network providers prefered
Healthcare Specialist Job Description
- 1-3 years of experience or proven ability working as an analyst, preferably in the health care industry, particularly with administrative healthcare claims and provider data preferred
- Proven experience working with Medicare and Commercial paid claims data sets
- Reasonable experience with Structured Query Language (SQL) required
- Maintains an organized day-to-day work environment handling multiple projects simultaneously
- Interpreting regulations and identifying compliance requirements
- Assessing likely risks and recommending compliant solutions that support business goals and serving as an expert
- Supporting workforce education about compliance requirements
- Assisting with benefit interpretation and drafting policy language to reflect compliance and business-driven changes
- Occasional work outside of normal work hours
- Perform other duties as assigned within the scope of responsibilities and requirements of the job
- Minimum requirement is High School diploma, college degree preferred
- Knowledge of insurance plans and financial classes
- Ability to effectively communicate through verbal, phone, or written communication
- Excellent decision making abilities and effective problem solving skills
- Daily Responsibilities will include telephonic outreach to targeted providers to educate the providers on data validation regulatory requirements and to secure practice information
- The expectation is to make 40 outbound calls per day, 5 per hour, averaging 12 minutes each
Healthcare Specialist Job Description
- Manages a lead list to meet enrollment goals
- Acts as a liaison between dialysis facilities, field operators and VillageHealth
- Consistently achieves metrics and goals set for the team, including enrollment rate and satisfaction scores
- Performs administrative tasks in support of enrollment operations
- Analyze and prioritize orders based on initial assessment of documentation and customer outreach
- Verify third party payer benefits and eligibility (online or telephonically)
- Review and analyze payer specific requirements and coverage criteria to determine required documentation and accurate billing criteria
- Call customer or field personnel to obtain missing documentation required for placement and/or billing
- Contact patient to coordinate delivery of product
- Follow-up post delivery to obtain any additional documentation to support billing criteria
- Candidate will be required to perform subsequent data entry of the providers updated practice information into our internal systems as needed, in addition to weekly reporting to CA leadership of telephonic outreach activities and compliance success
- Minimum of 1 year experience in behavioral healthcare related field
- Word and PowerPoint
- Candidate will be required to perform subsequent data entry of the providers updated practice information into internal systems as needed, in addition to weekly reporting to CA leadership of telephonic outreach activities and compliance success
- Experience in a diagnostics laboratory highly desired
- Medical ProFee Billing and CPC coding preferred
Healthcare Specialist Job Description
- Acts as a resource for Sales and other cross functional departments to provide order status and any other information
- Participates in any and all reasonable work activities as may be deemed suitable and assigned by management
- Regional healthcare specialist for assigned region & market
- Stimulate growth with target healthcare customers
- Evangelize the HP Healthcare value proposition for all product categories
- Maintain relationship with key customers and regional sales leaders focused on closing deals
- Collaborate with WW Healthcare team on strategic direction and insights driven from customers
- Develop training materials and conduct training classes and workshops
- Grasp a solid understanding of the Healthcare industry and the processes required on State Medicaid Fiscal Agent accounts
- Participates in the identification, documentation, analysis and validation of intermediate level business processes, systems, and solution requirements
- Familiarization with the imaging studio equipment and requirements
- 2+ years of imaging studio experience with strong desktop skills
- At least four years in a substantially similar position in a health care environment
- Basic knowledge of federal and state regulations and standards related to compliance in health care
- Basic knowledge of standard contract components and contract language
- Basic knowledge of compliance systems, processes and reporting
Healthcare Specialist Job Description
- Make recommendations for policy / procedure changes
- Researches and evaluates components of solutions to problems
- Able to resolve / recommend action on less complex issues
- Applies knowledge of business unit processes to support requirements of business unit
- Participates in process review and improvement initiatives
- Establishes customer satisfaction by responding to requests for data / service in a timely and quality manner, interpreting circumstances
- Manage multiple assignments with minimal supervision
- Manage requests from customers, leaders, and corporate executives
- Must be able to travel frequently (up to 60%) with the occasional overnight stay
- Work with business users to understand their business processes
- Strong oral and written communication skills with the ability to communicate professionally, effectively and persuasively to diverse individuals and groups
- Ability to effectively prioritize multiple tasks and meet agreed-on deadlines
- Ability to speak and be understood in English
- Experience building relationships and collaborating with employees and customers
- Previous experience in communicating in writing and verbally with employees and customers at all levels of an organization
- Previous experience prioritizing multiple deadlines