Organizational Expectations
Behavioral Attributes:
The following behavioral attributes are required: achievement motivation, concern for order, flexibility, initiative, self-confidence, customer service oriented, interpersonal effectiveness, teamwork, analytical thinking and information seeking.
Essential Functions
- Answers telephones, schedules in office appointments, takes messages accurately and routes appropriately
- Completes tasks associated with clinical inbox/ practice buckets (personal, practice referral, medical record and others assigned) proficiently and in a timely manner
- Completes tasks associated with workflow dashboard (Appointments to be rescheduled, appointment tickers, no shows and others assigned) proficiently and in a timely manner
- Arrives patients, verifies all required fields for most current, up to date patient information. Has patient complete appropriate forms, accurately documents information provided by patients in EMR and completes check-in.
- Departs patient from office, provides any necessary patient information and schedules appointments in office and outpatient appointments as needed
- Collects copays/payments, maintains records and reconciles daily deposits
- Verifies insurance coverage and eligibility and negates issues prior to patient visit whenever possible
- Performs a variety of clerical functions to support office such as typing, filing, scheduling appointments, making phone calls and related duties as required or directed.
- Process incoming faxes and daily mail including barcoding and document processing within EMR.
- Schedules and coordinates patient visits and medical procedures, for both inpatients and outpatients
- Registers patients utilizing computer-based registration/scheduling system
- Processes Medical Records incoming and outgoing according to practice guidelines and regulations
- Maintains assigned office and/or clinical supplies. Assures accurate inventory of supplies based on approved levels. Rotates stock as required. Initiates requisitions for re-supply or special items.
- Maintains records, reports, logs and other statistical information as required or directed.
SURGICAL SCHEDULER ROLE/RESPONSIBILITIES
- Schedules office and hospital based medical procedures, for patients with appropriate provider and time/location slot, utilizing appropriate scheduling codes.
- Schedules diagnostic and imaging tests. Schedules office and hospital-based procedures, tests and imaging ensuring available time is utilized to maximum efficiency.
- Interfaces with appropriate vendor staff to ensure all necessary equipment will be on site for office and hospital-based procedures.
- Interfaces with appropriate hospital staff to ensure a cohesive working relationship in providing patient care services.
- Enters notes/special instructions needed for scheduling in EMR.
- Effectively utilizes clinical knowledge when determining if appointment is consistent with the diagnosis/indications indicated by the provider.
- Completes accurate documentation of informed consent with patients for procedures and surgeries as needed.
- Provides accurate, detailed information to patients regarding test preparations, time of patients scheduled arrival, and any other directional information needed; takes appropriate action in responding to questions from patients.
- Confirms patient’s insurance provider and obtains all necessary prior authorizations or referrals appropriately.
- Ensures patients have proper medical clearance and pre-surgical testing as needed.
- Completes pre-procedure phone calls and confirms appointment times with patients via telephone
- Demonstrates use of quality improvement in daily operations
- Ensures completion of assessment for advanced directive, including DNR when applicable
REFERRAL AND PRIOR AUTHORIZATION SPECIALIST
- Schedules and coordinates patient referrals to ordered services expeditiously
- Establishes a close working relationship with preferred providers to facilitate scheduling
- Ensures any necessary paperwork, medical records and insurance referrals are processed and provided to specialty provider in advance of patient appointment
- Stays current with insurance referral and prior-authorization requirements
- Obtains necessary prior-authorizations for ordered procedures and diagnostic studies as required
- Issues patients managed care referrals as required
- Has working knowledge of our local network/preferred providers and works with practice providers and PHO to minimize leakage
- Closes the referral loop follow up on assigned open orders-results/consults pending
- Maintains records, reports, logs and other statistical information as required or directed
- Acts as office communications liaison for patients and healthcare providers for referrals and authorizations
- Assists in appeals process as directed
- Verifies insurance coverage and eligibility
- Completes PT-1 forms as required for patient transportation to scheduled services
- Completes tasks associated with clinical inbox/practice buckets (personal, practice referral, medical record and others assigned) proficiently and in a timely manner
- Thoughtfully communicates with patients regarding scheduled services, accurately providing any necessary information such as date, time, prep, pre-registration requirements, etc. in advance of the appointment
RESPONSIBILITY OF ALL JOB ROLES
- Actively participates in quality measure management
- Demonstrates use of quality improvement in daily operations
- Performs all aspects of patient care in an environment that organizes patient safety and reduces the likelihood of medical/health care errors.
- Assists other members of the department as needed
- Attends variety of meetings, conferences, and seminars as required or directed
- Complies with established departmental policies, procedures, and objectives
- Complies with all health and safety regulations and requirements
- Respects diverse views and approaches, and contributes in maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors. Attends all H.E.A.R.T trainings
- Provide coverage when needed at other locations within Heywood Medical Group.
- Completes all Annual Mandatory Education requirements.
- All other duties and locations as assigned.
Statement of Other Duties
This document describes the major duties and responsibilities for this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described.
