Overview
You Matter Here!Heywood Healthcare values our employees! We offer competitive wages, great benefits and generous earned time off. Come work where you will matter!
Hours: 40 Hours, Days/Evenings
Job Summary
Under the direction of the Senior/Practice Manager, the incumbent is responsible for scheduling surgeries (if applicable) and/or referral and prior authorization processing. As an Office Assistant II, you will utilize administrative/clinical knowledge to schedule appropriate procedures/surgeries per provider’s orders. You will act as a Surgical Scheduler to schedule office-based and hospital procedures consistent with the patient’s diagnosis and procedure request. You must be able to respond to both written and oral correspondences regarding scheduling changes/cancellations in a timely, accurate manner. The individual must be organized and able to manage a demanding workload with accuracy. You will also act as a Referral/Prior Authorization Specialist to ensure referrals are scheduled in a timely manner, maintain tracking and appropriate documentation of referrals and authorizations.
Responsibilities
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 the most current, up-to-date patient information. Has patients complete appropriate forms, accurately documents information provided by patients in EMR and completes check-in.
- Departs patients from the 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 the office such as typing, filing, scheduling appointments, making phone calls and related duties as required or directed.
- Processes 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 a 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, 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 the 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 a 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 to maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors. Attends all H.E.A.R.T trainings.
- Provides 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.
Qualifications
Job Requirements
Minimum Education
- High School diploma or equivalent required.
Minimum Work Experience
- Three (3) years of experience in a medical office preferred.
Required Skills
- Excellent written and verbal communication skills.
- Excellent customer service skills.
- Ability to prioritize tasks in a busy environment.
- General comfort level with computers/technology and ability to learn programs as needed.
- Knowledge of Electronic Medical Records preferred and word processing skills.
- Three (3) years of experience in a medical/surgical office preferred.
- Preferred knowledge of medical terminology.
- Must be able to work flexible shifts, some evenings & weekends may be required.
- Reliable transportation in order to travel between locations is also required.
Functional Demands
Physical Requirements
Exerts up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. Frequently reaches (extending hands and arms in any direction), and handles (seizing, holding, grasping, turning, or working with hands).