Location: Steward Health Care
Posted Date: 8/31/2022
Responsible for the efficient, expeditious and accurate scheduling of patients. Ensures Authorizations and/or Medical Necessity is obtained for patient’s scheduled appointment(s). Promotes positive guest relations. Processes numerous reports and statistics daily and forwards them to appropriate personnel. Advises patients on all amounts due from self-pay and/or insurance balances. Schedules patient exams in a timely manner, requesting previous exams as needed. Performs clerical duties as required for efficient day to day organization of patient records.
- Schedules patient (tests/exams) for ancillary services, accurately for all modalities.
- Perform Insurance Eligibility and Verification of Coverage, Update Patient Responsibility (copay/coins/deductible)
- If Authorization required, obtain Insurance Authorization # pre-patient service date.
- Perform Medical Necessity Checking for scheduled patient’s services.
- If Insurance denies service for Medical Necessity or Auth, notify patient/facility/ordering physician.
- If Patient cancels due to inability to meet financial obligations (ins non-covered), notify patient/facility/ordering physician.
- Screen physician order for compliance and consistently follows fax server process
- Meet or exceeds call center telephone scheduling performance
- Meet or exceeds professionalism and customer service interactions with internal and external customers
- Communicates effectively. Answers telephone calls by identifying name and department. Transfers calls or directs guest to needed location. Uses appropriate language and tone of voice, avoiding jargon.
- Maintains and protects issues of privacy & confidentiality.
- Ability to work independently and take initiative.
- Ability to demonstrate a commitment to continuous learning and to operationalize that learning.
- Ability to deal effectively with difficult people and/or difficult situations.
- Other duties as assigned.
REQUIRED KNOWLEDGE & SKILLS:
- Excellent customer service and communication skills
- Ability to discuss and collect patient financial responsibility
- Ability to work independently, prioritize and multi-task
- Medical terminology and/or insurance knowledge
- Bilingual; Spanish-speaking preferred.
- Education: High School Diploma or Equivalent Required
- Experience: Minimum of 1-2 years of experience in a scheduling or similar role. Preferred experience: 2+ year’s experience scheduling or in a similar role within a healthcare setting (preferably hospital)
- Software/Hardware: Microsoft Office and/or Medical Systems (e.g., Meditech)