GENERAL SUMMARY/ OVERVIEW STATEMENT:

The Patient Services Coordinator III functions within the ambulatory practice as the department team leader coordinating administrative functions within the practice while assisting the department administration with the effective management of the practice's daily operations and revenue enhancement.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Perform all duties and responsibilities of a PSC I and II at Front Desk.

Check-in / Check-out patients, answer phones, scheduling of appointments, prepares daily paperwork, faxing, responds to Patient Gateway messages, and populates and manages multiple provider schedules in Epic.

Conducts or arranges for unit specific training for new administrative hires, while coordinating with the practice-training mentor.

Manages the Referral Work queue and Outside referrals that come into the practice.

Follows and enforces all Covid 19 guidelines and protocols for patient screening and masking.

Works to ensure HIPAA Confidentiality and Privacy Policies is fully implemented.

Coordinates the workflow and schedules within the department to insure an efficient daily operation and troubleshoots workflow issues as needed.

Function as the department's "Super User" for EPIC CADENCE scheduling system including Template Building for provider schedules.

Identifies and communicates to the Practice's leadership issues of process creating inefficiencies within the operation. Assists in their resolution, working within the department and with management for the practice location.

Investigates and resolves issues relating to and arising from the referral and/or billing process, which interrupts the delivery of care to a patient or the reimbursement for services rendered. Addresses patient questions, complaints, and concerns. Works closely with Financial Staff for insurance requirements.

Functions as the department resource for referral and insurance issues. Remains current on the changing issues impacting the health care insurers for scheduling purposes.

Possesses a thorough knowledge of HMO, managed care, other third-party insurers, and available patient financial services/resources to assist patients and their families.

Assists with special projects as required. Projects may include such topics as obligations to insurers, hospital issues of compliance and/or Operations Improvement Initiatives.

Provides cross coverage for other Practice staff members for absences, vacations, etc. and during variations in workflow as needed.

Performs Surgical Booking, which includes coordinating PATA and other necessary appointments.

* Schedule's patient surgeries, pre-testing; completes, delivers, and files all associated paperwork in an accurate and timely manner.

* Confirms patients' arrival time for surgery.

* Is knowledgeable in the use of the MGH OR Schedule and Information System -OR Scheduling System, Epic and the PATA Online Scheduling pre-admission testing program.

* Schedules PATA, Pre-operative, and Post-Operative appointments in a timely and courteous manner; prepares appropriate paperwork and confirms that any necessary follow-up is scheduled at the appropriate time in the future.

* Ensures completed consents are scanned in EPIC.

* Consistently provides patients/family with copies of surgery instructions for appropriate type of admission.

* Ensures that required pre-authorization forms are filled out by either the physician or the nurse when necessary.

* Provides patients with surgery estimates when patient requests.

* Refers patients to Patient Financial Services for financial counseling as appropriate.

* Distributes information to patients pertaining to surgery and pre-admission testing, directions to appointments, maps, etc. (prior to surgery).

* Answers patient/family questions regarding appointments, surgical procedures, and pre-operative instructions as appropriate. Refer all medical questions to the appropriate person.

* Arranges for interpreter services as needed prior to patient's pre-operative, post-operative and PATA appointments, as well as day of surgery.

* Ensures that all demographic data in the patient's medical record is current and complete; directs to MGH Registration and Referral Center (RRC) if applicable.

* Re-schedules any cancelled surgeries in a timely manner.

* Responds to requests from billing service or third-party carriers for information, corrections, etc., related to the physician's surgical procedures.

* Ensures equipment requested by the physician is entered in the OR Scheduler. Schedule inter-op U/S guidance when requested by the physician.

* Request the presence of a company representative for new procedure when indicated.

* Assist other Gyn offices to find OR time outside of their block time when necessary.

* Sends a confirmation e-mail to the physician once the patient is confirmed for surgery. Enters the information into Epic.

* If a case will go beyond 5:30pm contact the appropriate OR Administrator to request approval.

QUALIFICATIONS:

Associate degree in Secretarial Science/Business, or a Secretarial Training Certificate Program preferred

Minimum of 3 years work experience in medical group practice, billing and/or managed care setting required.

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:

Demonstrated experience to interface with various levels of the practice with administration and clinicians.

Thorough knowledge of EPIC CADENCE system modules and its features, electronic

medical record modules.

Demonstrated ability to work independently, with limited supervision, resolve issues, be organized, attentive to detail and achieve outcomes within the team.

Demonstrates effective interpersonal and communication skills.

Effectively interacts with all levels of management and Urogynecology team to include MA'S, MD'S, RN'S, as well as peers.

Demonstrates knowledge of HIPAA Confidentiality and Privacy policies.

Demonstrates an understanding of Disaster protocols to include fire, safety, code calls, per the mandatory training, as outlined by MGH and JCAHO guidelines.