Pt Access Scheduler I - Wound Clinic

Tucson Medical Center; Tucson (AZ); On-site; USD 35,000 - 48,000; Full time

Job summary

Tucson Medical Center in Tucson, AZ is seeking an experienced Clerical professional to serve as the first point of contact for patients and to initiate entry for requested healthcare services and revenue management. The role includes patient registration, scheduling, and insurance verification to validate authorizations and benefits.

Responsibilities include cash handling, explaining forms, ensuring compliance, and coordinating with departments to ensure accurate data entry and timely patient

Qualifications

• High School diploma or GED; vocational medical office training preferred.
• Two years of medical office/hospital experience; includes six months eligibility/benefit analysis or scheduling for diagnostics/surgery.
• Heartsaver CPR certification required within 90 days for Pediatric and Adult Therapies departments.

Responsibilities

• Exhibits excellent customer service with patients, visitors and staff and upholds TMCH values.
• Collects deposits or deductibles and explains insurance benefits and costs.
• Completes financial documentation following credit/collection policies.
• Explains compliance forms and obtains signatures for regulatory agencies.
• Performs medical necessity screening and ensures system compliance.
• Assists outpatient departments with system maintenance and scheduling tasks.
• Communicates with physicians and staff to obtain diagnoses, procedure details, or authorizations.
• Coordinates with Medical Records and Professional Staff Services as needed.
• Uses scheduling knowledge to select correct procedures and coordinate with departments.
• Knowledge of resources, staffing, and equipment to avoid scheduling conflicts.
• Registers patients to ensure accurate data entry into hospital records.
• Performs insurance processing including verification, authorization and notifications.
• Handles calls and schedules appointments for patients, physicians, and staff.
• Explains procedure preparations to patients for hospital visits.
• Documents notification, authorization, and eligibility in registration systems.

Skills

Customer service

Scheduling

Insurance verification

Medical terminology

Cash handling

Communication

Education

High School Diploma

Medical Office Training

Tools

EMR/EHR Systems

Job description

Job Category: Clerical

Schedule: Full time

Shift: 1 - Day Shift

SUMMARY:

Serves as first point of contact for customers of TMC HealthCare; initiates the entry point for requested healthcare services and revenue management. Responsible for computerized patient registration and scheduling as well as insurance verification to include validation of authorizations and/or benefits information for ancillary procedures. Maintains and fosters effective public relations with patients and visitors.

ESSENTIAL FUNCTIONS:

• Exhibits excellence in customer service through appropriate attitude and interaction with all patients, visitors and staff; adheres to and supports team members in exhibiting TMCH values of integrity, community, compassion, and dedication.
• Collects deposits or deductibles and advises patient or guarantor of insurance benefits and anticipated cost estimates; ensures that cash handling follows corporate policies.
• Ensures completion of financial documentation in accordance with TMCH’s credit and collection policies.
• Explains all necessary compliance forms and obtains patient signature as required for regulatory agencies.
• Performs medical necessity screening and ensures compliance with system requirements.
• Assists outpatient departments with minor system maintenance, to include closing resources, opening resources, performing overbook and override as requested.
• Interacts with physicians and/or physicians’ office staff to secure diagnosis, procedure details or authorization information as needed.
• Communicates with Medical Records and Professional Staff Services as necessary.
• Uses medical terminology and scheduling knowledge to select correct procedure when scheduling and coordinates information with other departments as needed.
• Demonstrates knowledge of resources, staffing, instrumentation, and equipment specific to procedures to avoid scheduling conflicts.
• Performs patient registration activities to ensure accurate financial and biographical data and documentation have been obtained and properly entered into hospital records.
• Completes insurance processing; including account creation, insurance verification, notification, and authorization functions
• Communicates with departments/physicians for special requests, emergent cases, overbooking and add-ons; informs management about issues/problems with tools/times.
• Handles incoming telephone calls and exercises judgment in scheduling caller for correct procedure in appropriate service area; receives telephone requests to schedule from patients, physicians, physician office staff, employers, and hospital personnel, if applicable.
• Explains procedure preparations to patients so they are properly prepared before arriving at the hospital as needed.
• Documents all notification, authorization and eligibility information in the registration systems, uses electronic verification tools and web-based resources.
• Adheres to TMCH organizational and department-specific safety, confidentiality, values policies and standards.
• Reconciles daily cash drawer.
• May prepare and reconcile daily deposits.
• Performs related duties as assigned.

MINIMUM QUALIFICATIONS

EDUCATION: High School diploma or General Education Degree (GED), completion of vocational medical office training desired, or an equivalent combination of relevant education and experience.

EXPERIENCE: Two (2) years of medical office and/or hospital experience to include six months healthcare eligibility and benefit analysis or scheduling experience for diagnostic testing and/or surgery.

LICENSURE OR CERTIFICATION: Heartsaver CPR (HSCPR or HSFACPR) certification required within ninety (90) days of employment for Pediatric Therapies and Adult Therapies departments only.

KNOWLEDGE, SKILLS AND ABILITIES:

• Knowledge of office management practices, including billing and scheduling within healthcare.
• Ability to read or listen and comprehend simple instructions, short correspondence, and memos.
• Ability to write simple correspondence; ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
• Ability to read and interpret documents such as safety rules, procedure manuals, and governmental regulations.
• Ability to effectively present information and respond to inquiries or complaints from patients and/or their representatives and the general public.
• Ability to interpret and explain insurance benefits and patient financial responsibility.
• Ability to apply common sense understanding to carry out simple/detailed written or oral instructions.
• Applicants must have basic computer familiarity and experience and the ability to operate basic office equipment.