About the Role
The primary function of the Appeals Specialist is to support the Utilization Review (UR) Appeals process within the Department of Patient Accounts by providing follow-up and administrative assistance. This role involves entering, tracking, and analyzing appeal-related data, coordinating with external managed care organizations, physicians, and case managers, and assisting in the preparation of appeal documentation. The Appeals Specialist is also responsible for maintaining detailed logs and generating reports as needed.
About the Role
The Patient Navigator (PN) for the Breast Imaging Center is responsible for guiding and supporting patients through breast cancer screening, diagnostic work, and the treatment processes. The PN ensures seamless care coordination and effective communication among patients, providers, and healthcare teams. Oversees BIRADS tracking for patients and navigates positive results accordingly. The PN serves as a patient advocate and will guide patients through the health care system, ensuring appropriate appointments are given in a timely manner, following guidelines established with the Radiologist, Chairperson of Radiology, and/or the Executive...
