Author Archives: Zach Kohlmeier

Grievance and Appeals Rep

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The grievance and appeals representative is responsible for reviewing, analyzing, and processing policies associated to claim events to establish what the company’s liability and entitlement will be. Grievances are complaints made regarding providers or how a benefit decision was determined.

Job Duties and Responsibilities

  • Research complaints (grievances) and log and track the information as it moves through the clinical process or is tasked through internal contacts
  • Contact customers to collect information and communicate disposition of the case, document all interactions
  • Review cases to determine if it needs further review by a clinician
  • Use sound, fact-based decision-making skills to render a decision for non-clinical complaints
  • Use appropriate templates to complete necessary documentation for final appeals or grievance determination
  • Relay appeal or grievance information to members, providers, and internal/external parties within the appropriate timeframe
  • Create weekly statistical reports and prepares appeal hearings

Education and Qualifications

  • HS diploma or GED
  • 1+ year of work experience in a similar environment
  • Strong written communication skills, especially with grammar and spelling
  • Attention to detail and accuracy
  • Strong computer skills, must be able to run reports and manipulate/track/log data
  • Knowledge of Microsoft programs and CMS Guidelines
  • Experience with healthcare, medical, or pharmacy terminology is preferred

To be successful in the appeals and grievance representative role, you’ll need to possess strong analytical skills and effectively interact with other departments to attain original claims processing details.

Mary B

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I worked for HSS for a little over 2 years mostly on the same project. when it came time to become a permanent employee with the company I was contracting with, Paul Martinez was a great help in getting information I needed to update my resume.
When I was hired as a permanent employee it was kind of sad leaving Paula because she was great when ever I had a question about anything, if she did not know she would find out who did and work to resolve it the same day!
If you are thinking of joining HSS, do it!! They are a great company to work for!

Common Interview Questions Asked During a Nursing Interview

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If you’ve landed an interview for a nursing position, you’ll want to spend some time reviewing common interview questions so that you’ll feel well prepared and confident when responding. Keep your answers focused and positive while giving examples of similar situations you may have encountered in the past that resulted in a successful outcome. Following are some answers to common questions you may be asked during a nursing interview.

Do you work better alone or as part of a team?

I believe that nursing is a team effort, and I enjoy contributing to a team, but I also appreciate the one-on-one time I have with my patients.

How would you handle a situation where a patient complains of having constant pain?

I would be sympathetic to their complaint and reassure the patient I am hearing everything they are saying while doing the best I can to make them as comfortable as possible.

How do you handle stress while on duty?

I handle stress by focusing on the care of the patient, which to me is the most important thing. If I overreact, it could upset the patient, so I do my best to stay calm and focused for them.

What do you feel is most rewarding about being a nurse?

I find helping patients through the recovery process to be most rewarding. No matter how prepared or educated you feel before having major surgery, you can never fully know how your body will react and or how fast you can get back to your usual routine while recovering. Post-surgical rehabilitation can be overwhelming, but I take pride in going above and beyond in making sure patients get the best care imaginable.

What do you feel is most challenging about being a nurse?

Because I am very involved with my patients and tend to see them as family, I think the most challenging part of being a nurse is having to leave work. Before the end of each shift, I do my best to make sure the other nurses understand all of the details involved in each patient’s case I’ve been working on to ensure the patient receives the best care from all the staff at our facility.

How has your prior training prepared you for a nursing career?

Nursing is unique in the sense that it’s both a science because of the technical skills and knowledge you possess, as well as an art because of the wisdom, compassion, and empathy you carry for your patients.

Why do you want to work here?

Upon researching this organization, I see myself being a good fit for this company because I agree with its vision, mission, and value statements.

How do you keep current with medical findings and practices?

Continuing my education is necessary for renewing my license as well as keeping skills fresh, while at the same time expanding my knowledge base by networking professionally.

Why did you want to become a nurse?

I wanted to work in an exciting career where I felt challenged. I like the variety of the nursing routine, and at the same time, I get to make a difference in people’s lives on a daily basis.

Why should we hire you?

I am a team player who is loyal to my work. I understand how not giving my best every shift could affect my team as well as my patients. I am comfortable as a leader and take pride in working to ease my patient’s fears while alleviating their stress during procedures.

Landing a job as a nurse takes more than just interviewing questions well. Along with researching and preparing for the interview, you’ll want to make sure to dress appropriately. If you feel like you’ve done everything you can on your own to obtain a nursing career, but are still having trouble being hired, look into working with a recruitment agency that specializes in the healthcare industry.

At HealthCare Support (HSS), our recruitment firm has earned partnerships with prestigious healthcare organizations, which can help get you placed into the dynamic healthcare industry. We have experience putting administrative to executive level professionals in both clinical and non-clinical areas. To learn more about how we can help you begin your nursing career, along with other information relating to the services we provide, please call us at 407-478-0332.

Looking to Start a Career in Healthcare? Become a Triage Nurse.

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Triage nurses play a vital role in the medical field. While working in a hospital, the triage nurse is first responsible for making an initial assessment, including a quick physical and mental evaluation, of all incoming patients in the emergency room.

To be successful in this position, you must be able to make fast decisions about the order in which patients need to receive treatment based on their medical needs. While this may seem like an easy task, it can be hard for many to handle the pressures of working in a continuously hectic and chaotic environment.

Education and Certification Requirements

To begin working in triage, you should complete a nursing degree program at an accredited school. Once you attain a formal degree, you can sit for the NCLEX-RN licensing exam. Earning an RN license will allow you to practice in a variety of settings.

Responsibilities of a Triage Nurse

As a triage nurse, you will need to understand how to quickly and correctly prioritize which patients will be seen in what order in accordance with need. The priority level of a patient depends on where their injury is sustained and is sorted by low priority, high priority, very high priority, and highest priority. Other daily responsibilities will include:

  • Writing down relevant medical history
  • Identifying whether a patient takes medications or suffers from allergies
  • Measuring a patient’s weight, blood pressure, height, heart rate, and body temperature
  • Cleaning and bandaging wounds
  • Taking blood samples
  • Providing patients with medications
  • Stocking medical equipment supplies
  • Moving patients to proper location

As more of the population gain access to healthcare, the demand for nurses working in the triage department continues to rise. Although the work environment can be stressful, you will be part of a rewarding career, by helping patients on a daily basis who are injured or ill.

If you’re looking to begin a career as a triage nurse, we can assist you with the resources you need. At HealthCare Support (HSS), we pride ourselves on being a trusted employment partner to many of the nation’s top healthcare organizations.

Our team of healthcare recruiters can help match you to employment opportunities which can help advance your career in both clinical and non-clinical settings. To discuss recruiting options with HSS, contact us today by calling 407-478-0332.

Not All Medical Staffing Agencies Are the Same

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Working in an industry such as healthcare requires staff to provide around-the-clock care for their patients. However, just like in every other industry, healthcare staff need time off as well, whether it be for medical or personal reasons.

Partnering with a medical staffing agency will allow you to fill the role in their absence while continuing the level of care your patients expect and deserve. But because not all medical staffing agencies are the same, how do you know which firm will best suit the needs of your unique facility?

Consider the following factors to ensure you partner with the right medical staffing agency next time you have a “temp to hire” emergency.

Look at their website as a first impression 

The information on a company’s website is an excellent indicator of what the agency is all about. Read through the content on the site to better understand their mission statement and the information regarding their team and culture. You will get a good idea if the agency can provide your business with the best resources and most qualified talent.

Take the screening process seriously

After checking the website, call to set up a phone or in-person meeting to learn more about the agency’s screening and credentialing processes. This step is a significant one and shouldn’t be taken lightly, as your patients will be directly impacted based on who you choose to hire. If the agency you decide to work with doesn’t adequately screen their healthcare professionals, your business could be negatively affected.

Read through reviews and address any concerns

– For an unbiased opinion, check out any reviews that are offered online regarding the agency you’re interested in working with. In addition to reading the information located in the testimonial section of the agency’s website, ask your network of partners if they have any experience with the staffing firm you want to hire.

Choose quality over quantity

Many healthcare facilities make the mistake of working with several staffing agencies at once, keeping multiple options open in the event an emergency should happen. While the strategy seems to make sense, it can cause inconsistency among patient care.

Partnering with a single staffing agency will allow you to establish clear, ongoing communication while building a healthy working relationship to ensure the quality and consistency of patient care. When the staffing agency becomes more familiar with your facility, they can better provide you with healthcare professionals who will best suit your patient’s needs.

Choosing a medical staffing agency may seem like a simple process, but choosing one that best fits your organization takes time, effort, and research. By carefully selecting which firm to hire, you can give the patients of your facility the quality care they deserve.

Recognized as the 11th largest allied healthcare staffing firm in the U.S. by Staffing Industry Analysts 2017, 2016, and 2015, you can trust us to be your employment partner! Call us today at 407-478-0332 for more information on the several flexible placement options we provide to help you reach your hiring goals.

 

The Most Sought-After Healthcare Occupations in 2018

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As baby boomers get older and Generation X has children, the demand for healthcare professionals will be higher than ever before. With healthcare jobs expected to grow by 22% in 2018, it’s easy to see why choosing a healthcare career is a smart move. If you’re interested in getting into the healthcare field, check out some of the most sought-after occupations.

Registered nurses

are one of the most in-demand careers in the entire United States. Those who follow the path to becoming a nurse will find ample job opportunities. Registered nurses assist physicians with providing treatment to patients who suffer from various medical conditions by administering medication, monitoring patient recovery and progress, and educating patients and their families on prevention and post-hospital care.

Home health aides

function as a caregiver to those who can’t leave their homes or live on their own. Job duties of a home health aide may include checking vital signs, administering medicines, and helping with daily tasks.

Medical assistants

complete a variety of administrative and clinical tasks in various work settings, including physician’s offices, hospitals, and other healthcare facilities.

Pharmacy technicians

assist pharmacists in providing medication and healthcare products to patients. While technicians don’t answer questions regarding prescriptions, they help count tablets, label bottles, and perform administrative duties.

Medical secretaries

complete clerical duties in a medical office, which usually includes typing, maintaining files, and billing. Medical secretaries communicate with the public throughout the day by taking phone calls, making appointments, and greeting patients.

Dental assistants

carry out numerous tasks such as sterilizing instruments, taking x-rays, and teaching patients about the importance of dental care.

Medical records and health information technicians

manage millions of documents such as x-rays, medical histories, lab tests, and treatment plans produced by the healthcare industry. Each patient seen by a physician has detailed medical records, and their information needs to be kept organized and confidential.

Physical therapists

work with various kinds of patients including the disabled, the elderly, and those with general pain. Physical therapists examine each patient, develop a treatment plan, and implement specific treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability.

EMT and paramedics

are dispatched by emergency operators in the event of medical emergencies such as car accidents, childbirth, violent traumas, heart attacks, and traumas. EMT and paramedics work in multiple settings including ambulances, hospitals, and helicopters, and are relied on to react quickly and be able to handle considerable amounts of stress.

Individuals who work in the healthcare industry contribute not only to the health of a person but their social well-being as well. If you’re interested in working in one of the most sought-after healthcare careers, we can help! HealthCare Support (HSS) is dedicated to placing top talent into the dynamic healthcare industry. To begin your partnership with us, join our Talent Network to enhance your job search and application process or apply to one of our current job openings.

Healthcare Technology Trends to Watch in 2018

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In 2017, health-tech trends focused on finding solutions for patient empowerment through new payment structures, cost pressures, and system integration. Digital transformation is expected to overhaul the healthcare industry in 2018 by using personalized medicine and value-based care.

Precision Medicine

While there are standard practices for treatment plans based on your medical needs, not all patients have the same misspellings and will benefit from treatment in the same way. For example with cancer, misspellings or mutations in important genes force the cells to grow out of control, eventually spreading throughout the body.

As physicians progress through different therapies without knowledge on which will prove effective, valuable time is being lost. Precision medicine will help to deter unnecessary treatment, minimize detrimental drug events, and increase overall safety, ultimately helping the healthcare system to be more efficient.

Real-Time Monitoring

By using non-invasive monitoring, patient data is collected longitudinally across various time points. This is due to different sensors which track patient vital signs 24 hours a day, through wearable devices accomplished by blood and saliva monitoring techniques. Identifying correct treatments and tracking their impact as soon as possible helps open up opportunities to improve healthcare.

Real-Time Personalization

Treatment strategies for patients need to evolve due to the changing of treatment pressures and other reasons. Having the ability to monitor the impact of treatment on a disease creates the opportunity to learn why a treatment is not working and what new course of action should be taken.

Use of Big Data

The growth of Internet of Medical Things (IoMT), along with mobile and wearable devices, allows healthcare providers to access a patient’s medical reports from anywhere quickly. The data retrieved can then be used to identify health dangers and provide patients with lifesaving preventative treatment almost immediately.

Mobility and Cloud

Mobility and cloud access has improved the way patients and doctors interact. Most doctors use smartphones and medical apps on a regular basis. However, hospitals, insurance companies, and doctors offices are now storing medical records of the patient into the cloud. Mobile devices can now perform ECGs, DIY blood tests, and serve as a thermometer. Patients are also able to enter their checkup/health results which doctors can quickly access as well as retrieve their test results 24/7.

The rise of digital technology within the healthcare industry and the improvements in overall clinical care for patients are becoming more unified, and with that, are improving the way healthcare facilities function as a whole.

At HealthCare Support (HSS), we understand the continually changing recruiting and hiring challenges healthcare organizations face while trying to keep up with the demands of the always evolving healthcare industry. We’re here to help you by offering several placement options. For more information on the services we provide, call us today at 1-407-478-0332.

AR Rep

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Accounts receivable representatives provide financial, clerical, and administrative services to ensure efficient, timely, and accurate payment of accounts.

Job Duties and Responsibilities

  • Collect on refunding/crediting balances, workers compensation, corporate billing accounts, self-pay, travel health insurance claims, and insurance collections
  • Collect on drug screens and pre-employment physicals for corporate accounts
  • Accurately and thoroughly document the relevant collection activity performed
  • Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers
  • Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory
  • Inform management of any issues such as payer, system, or escalated account.
  • Respond promptly to telephone messages and emails as needed

Education and Qualifications

  • High school diploma or GED equivalent
  • (6) months- 1+ years of healthcare insurance collections
  • 2+ years of medical AR/collections and billing experience
  • Experience with processing refunds and denials
  • Great data entry skills
  • Organized with great attention to detail

General math skills

Phlebotomist

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A phlebotomist draws blood from patients. After the blood is drawn, a phlebotomist takes the blood samples to the laboratory to check for further health issues such as disease, bacteria, cholesterol, etc.

Job Duties and Responsibilities

  • Collect blood samples from patients
  • Verify test demands by comparing information with nursing station log, as well as informing unit personnel of any discrepancies
  • Read patient identification to verify patient
  • Use the best method for drawing blood depending on the patient
  • Collect therapeutic drug monitoring analysis
  • Practice infection control requirements at all times when working with patients and equipment
  • Track collected specimens and initial, date, and note times of collection
  • Monitor glucose levels, record results, and report them to the unit nurse manager
  • Contact the physician, pathologist, nursing station, or reference laboratory to resolve unusual test orders

Education and Qualifications

  • High school diploma or GED equivalent (Associates degree preferred)
  • Must possess a valid state phlebotomy certification
  • Strong attention to detail

Excellent patient service and relationship skills

DME Nurse Case Manager

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A Durable Medical Equipment (DME) nurse case manager is responsible for coordinating with medical providers, injured workers, and carriers through the management of the DME process. The goal of the case manager is to facilitate DME needed for medical purposes by patients for self-care in a home setting.

Job Duties and Responsibilities

  • Requests for prior authorization of DME
  • Review provider requests by telephone or through fax to ensure medical necessity for services that require pre-authorization
  • Assist in ordering medical equipment needed for patient during recovery from surgery or for long-term use
  • Apply nationally recognized criteria to determine medical necessity of services requested
  • Refer provider requests appropriately to the medical director when medical obligation of services is not met based on criteria

Education and Qualifications

  • High school diploma or GED equivalent
  • Possess good communication skills
  • Attention to detail
  • Must have previous DME/Utilization Review/Prior Authorization experience
  • Management experience is preferred
  • Must be computer proficient: Microsoft Office, Word, and Excel, typing skills 30 WPM or above