Summary
Greets, provides information, and responds to the needs of patients, families, staff, and other visitors at the check-in/out desk including appointment check-in and out, registration, authorization/verification of insurance(s), explanation of benefits; collection of co-pays, assistance with way finding, or other services or resources for a program specific multi-discipline department. Interacts in a customer focused manner during referral processing. Provides office support for all Scheduling and Patient Financial Services staff. Works cooperatively with other departments and outpatient staff/leadership to assure financial reimbursement for outpatient services.
Essential Job Responsibilities:
- Greet, provide information, and respond to the needs of patients, families, staff, and other visitors at the check-in/out desk. Triage inquiries that arise during or after each patient/visitor/staff encounter. Escort and/or direct patients and other parties to other service areas or locations.
- Review referrals and other documentation according to internal policy and regulation as applicable in order to assure that the service being provided has been appropriately documented and meets all known payer medical necessity and other criteria.
- Review appropriateness of ICD10 and CPT codes to determine if care provided corresponds to reason for referral/authorization to ensure that patient's insurance covers the evaluation/treatments.
- Accurately collect and analyze all required demographic, insurance/financial, and clinical data elements necessary to pre-register and register all types of patients. Accurately record and electronically enter the information on a timely basis into EMR to include assigning a medical record number to new patients. Accurately prepare and distribute all required registration forms to other internal parties as appropriate and on a timely basis.
- Secure and witness all required signatures according to internal policy and regulation, as applicable with explanation of documents per department standards, including consent to treat, assignment of insurance benefits, Release of Information, Advance Beneficiary Notification, and financial responsibility. Forward appropriate documents/information to the Patient Financial Services Department to support billing and collections and other departments as needed.
- Accurately generate patient specific Explanation of Benefit Forms/Patient Benefit Summary for the multi-disciplinary cost (multiple copays per day and total coinsurance for multiple disciplines if applicable) and distribute to patients/representatives and appropriate internal parties on a timely basis. Upload the information to the EMR and accurately update information on MFB TeamSite.
- Coordinate/schedule initial evaluation and subsequent patient appointments for multi-disciplines based on patient needs (finding appointments for PT/OT/SP on the same day or times that run concurrently) following scheduling protocols and using MFB TeamSite for all patient referrals, follow-ups and authorization tracking. Inform UR if multiple services will be using the same authorization for visits used.
- Obtain, monitor and update insurance authorizations for multi-disciplinary patients (cross-monitor authorizations when PT/OT/SP are all combined and count towards the number of approved visits, monitor/coordinate authorization usage with other departments i.e. patient is being seen for same services in two different service programs).
- Coordinate and follow-up on multi-disciplinary patients with designated diagnosis, i.e. post-concussion, to ensure they receive all necessary program-specific care (clinic visit, psychology, nutrition, rec therapy) in addition to the necessary therapies. Obtain specialty program authorization as needed (i.e. cognitive speech therapy).
- Manage calls from insurance/care managers to coordinate multi discipline care for patients.
- Update patient insurance records upon notification of health plan change including monthly Medicaid updates.
- Collect any expected charge for service provided and complete timely posting of cash collections, accepting and generating appropriate receipts for monies and credit card payments received. Provide financial guidance to achieve a mutually acceptable resolution of the expected self-pay balance including options of payment and charity care.
- Receive and properly respond to telephone, electronic, or face-to-face inquiries from patients or their legal representatives.
- Manage telephone Call Back Reminder system for patient evaluations and appointments.
- Perform all other appropriate activities as directed and as necessary to meet the patient's needs and to achieve expected departmental and organizational outcomes.
- Provide various other responsibilities and clerical/therapist support as delegated by Manager.
Essential Job Qualifications (Knowledge, Education, and Training Requirements)
- Associates Degree or equivalent business classes/experience
- Computer experience with high accuracy level of data entry.
- Excellent telephone and customer service skills.
- Minimum 12-18 months work experience in healthcare with scheduling and/or PFS related job duties.
- Working knowledge of ICD-9-CM and CPT coding classification systems.
- Outstanding organizational, interpersonal, communication, and overall customer service skills.
- Ability to perform in a high paced environment with a positive attitude and interact with professional staff in an appropriate manner.
- Knowledge of medical terminology and clinical rehabilitation.
- Must have excellent attention to detail with the ability to quickly learn and retain a large amount of specific protocols and processes including learning Mary Free Bed scheduling software.
- Physical Demands: Able to exert up to 10 pounds of force occasionally (up to 1/3 of the time); able to lift, carry, push, pull, up to 10 pounds occasionally; able to sit for the majority of the time, nut may involve brief periods of time involving walking or standing; able to use keyboard frequently (1/3 to 2/3 of the time)
Other Preferred Job Qualifications:
- Bachelor's Degree in a health-related field
Mary Free Bed is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, genetic information, veteran status, disability or other legally protected characteristic.
