Outpatient Scheduling Coordinator - 40hrs/Day Shift

MINIMUM REQUIREMENTS:

• High school diploma or equivalent required

• Previous patient appointment scheduling and patient registration preferred

• One (1) to three (3) years administrative and in-person customer service experience required, preferably in a health care setting

• Demonstrated knowledge of medical terminology required

• Spelling and typing competence with computer experience essential

• Familiarity with and understanding of most hospital outpatient exams, major health insurers, and general coverage issues preferred

• Excellent oral and written communication skills required; the ability to communicate effectively with the public, physicians and all hospital personnel in a high volume setting; and the ability to multi task required

ESSENTIAL JOB FUNCTIONS:

• Accurately schedule any outpatient ancillary service as outlined by departmental policy and procedures either directly with patients or at the request of the physician's office.

• Explain multiple examinations, scheduling options, and exam preparations.

• Interview incoming patients, or their representative, to obtain all pertinent and financial information required for the proper preparation of all forms and records.

• Accurately and comprehensively collect and verify demographic and insurance information from patients and/or their representatives and enter it into applicable databases in a sensitive and timely manner.

• Verify patient insurance coverage with Third Party Payers and determine eligibility by utilizing appropriate applications.

• Work productively with all members of the Central Registration Team. Accept and contribute to all goals and objectives established by management.

• Receive referral and orders from physician offices, patients, their representatives, and visiting nurse associations. Schedule patients according to location of service requested utilizing the current scheduling system. Instruct patients and/or physician offices of patient prep instructions.

• Interact effectively with patients and doctor's offices in order to gather correct, complete data necessary to ensure that clinical and fiscal responsibilities are facilitated, for both the patient and the hospital. Follow manual procedures when computer system is not functioning properly.

• Provide excellent customer service to both internal and external customers. Strive for the goal of achieving a positive experience for the patient.

• Schedule all patients' appointments via the current scheduling system. Notify physicians' offices and insurance companies if a prior authorization is required. Educate patients and their representatives about insurance authorizations as needed. Perform medical necessity checks and advise physician's office if additional information is required. Follow insurance guidelines and keep up to date with all insurance requirements and stipulations in order to obtain reimbursement.

• Maintain scheduling work lists which includes the order requiring appointment, appointment requiring order, fax backs, call backs, etc. in a timely manner.

• Effectively work within multiple computer systems to complete all scheduling tasks.

• Call patients at home when needed to verify information and to reschedule and/or remind of appointments.

• Stay current with new regulations of the many public and private insurance companies which patients carry; such as Medicare, Blue Cross HMO's, Health New England, Tufts, Worker's Comp, and Liability - pre-authorization approval guidelines. Utilize eligibility checkers such as Emdeon, Medifax, NEHEN and various websites. Follow guidelines in order to attain the appropriately benefit, eligibility and co-payment information and update the Hospital based computer system accordingly.

• Advise non insured patients of Hampshire Health Connect and provide contact information.

• Provide patient information in accordance with regulations governing divulgence of information (HIPAA).

• Maintain confidentiality of all patients' records and data. Interface with medical records and billing department as required based on department, hospital, and patient care needs.

• Provide coverage for extra shifts in case of unexpected absence of staff members or for vacation coverage for patient care needs. Work a flexible schedule as needed for business purposes.

• Maintain established hospital and departmental policies and procedures, objectives, confidentiality, quality improvement program, compliance, safety, infection control and environmental standards.

• Maintain professional growth and development through attendance at seminars, workshops, conferences or in-services, professional affiliations or journals to stay abreast of current trends in field of expertise.

• Meet annual competency and retraining requirements.

• Attend meetings as required.

• Perform other functions/duties as requested.