Medical Assistant or Licensed Practical Nurse Clinic - Internal Medicine Job at Advocate Aurora Health (Grafton)

Nurse Practitioner Internal Medicine

Location

United States , Concord

Salary:

55.00 - 80.00 USD / Hour

Emerson Hospital

Expiration Date

Until further notice

Requirements

Advanced Practice Registered Nurse (ARPN), Completion of a Masters' Degree or Doctoral Degree
3+ years experience in primary care/family medicine
Current license as a Nurse Practitioner in the Commonwealth of Massachusetts required
National certification as a Nurse Practitioner required (ARNP) with recertification every five years as required
DEA license
BLS healthcare provider required
Must be able to attain and maintain privileges at Emerson Hospital as Nurse Practitioner
Computer skills required (EMR is GE Centricity)
Understands and is committed to maintaining highest level of confidential information
Demonstrated ability to work effectively independently and as part of a team, in collaborative settings, required

Job Responsibility

Reporting to the Practice Manager, and under general supervision and direct collaboration with the Supervising Physician, the nurse practitioner performs duties to assist supervising physicians in a wide range of clinical tasks
Responsible for managing a wide range of outpatient duties, as well as emergency situations, while adhering to standard practices and established procedures
This position ensures the quality and safe delivery of care to patients of all ages

Fulltime

Medical Appeals/Grievance Specialist II - Registered Nurse

Responsible for utilizing clinical acumen and managed care expertise related to ...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

1 year experience in clinical and health insurance or other healthcare related field
3 years experience in clinical and health insurance or other healthcare related field AND 1 year Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)
5 years experience in clinical and health insurance or other healthcare related field AND 2 years Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)
8 years experience in clinical and health insurance or other healthcare related field AND 3 years above satisfactory job performance in the managed care environment with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)
Associate’s Degree in a healthcare field of study or Nursing Diploma
Active, current, and unrestricted license to practice in the State of Arizona (a state in the United States) or a compact state as a Registered Nurse (RN), a Physical Therapist (PT) or a Licensed Master Social Worker LMSW.
Intermediate PC proficiency
Intermediate skill using office equipment, including copiers, fax machines, scanner and telephones
Maintain confidentiality and privacy
Advanced clinical knowledge

Job Responsibility

Perform in-depth analysis, clinical review and resolution of provider appeals/inquiries, corrected claims and subscriber reconsiderations, member appeals, corrected claims and provider grievances for all lines of business
Identify, research, process, resolve and respond to customer inquiries primarily through written / verbal communication.
Respond to a diverse and high volume of health insurance appeal related correspondence on a daily basis.
Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of appeal, grievance and reconsideration requests.
Maintain complete and accurate records per department policy.
Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations.
Demonstrate ability to apply plan policies and procedures effectively.
Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.
Attend staff and interdepartmental meetings.
Participate in continuing education and current developments in the fields of medicine and managed care.

Fulltime

Medical Assistant or LPN - Internal Medicine

You will be helping our patients live well by preparing and rooming patients, pe...

Location

United States , Neenah

Salary:

21.85 - 36.15 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

LPN: Licensed Practical Nurse (LPN) Active License issued by the state in which the team member practices
Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association (AHA) needs to be obtained within 45 days unless department leader has determined it is not required
Medical Assistant: Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association (AHA) needs to be obtained within 45 days unless department leader has determined it is not required
LPN: Advanced training beyond High School that includes the completion of an accredited or approved program in Practical Nursing
Medical Assistant: GED or HS Equivalency Diploma
Completion of an accredited or approved program in Medical Assistant, or 2 years of verifiable full-time experience as a Medical Assistant within the last 5 years
Ability to perform routine and complex technical skills, within the Medical Assistant scope of practice after demonstrated competency
Excellent communication and interpersonal skills
ability to develop rapport and maintain positive, professional relationships with a variety of patients, team members and physicians
Proficient computer skills including keyboarding, navigation within a windows operating system, and use of electronic mail with exposure to electronic medical records systems

Job Responsibility

Prepares and rooms the patient for exam by obtaining vital signs and gathering/documenting/updating pertinent health information
Monitors and completes Clinical Integration/ Quality Improvement measures with notification to clinician for opportunities within their scope
Performs laboratory procedures using principles of aseptic technique and standard precautions/infection control guidelines
Assists the Physician/ Advanced Practice Clinician (APC) with procedures such as pelvic exams, allergy scratch testing, EMG, cautery, colposcopy, etc
Administers routine medications, under Physician/ APC orders or medical group approved standing orders/protocols
Follows through with necessary procedure or test requests, pre-approved care algorithms, new appointment times and referrals to other facilities or services
Communicates with Physician/APC and other members of the health care team to ensure smooth clinic flow and adjusts as necessary
Effectively communicates accurate and timely information with the patient
May perform basic and advanced clinical support tasks or skills based on the specialty and appropriate competencies such as removal of sutures and staples, laboratory procedures, phlebotomy, EKG, spirometry, Holter monitor application, prescription refills using approved protocols, etc., under clinical supervision
Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Sign-on bonus for Qualified External Candidates

Fulltime