The Scheduling Specialist gathers from physician offices and/or patient information in order to schedule outpatient procedures. Ensures that patients are scheduled in a timely and appropriate manner obtaining all necessary information, interviews and pre-registers patients for outpatient /inpatient procedures, reviews all inpatient and observation admissions, and contacts the pre-certification company to provide demographic and admission diagnosis.
RESPONSIBILITIES:
* Interviews patients or their representatives by phone/person obtaining personal information or verifying information on file including emergency phone numbers and insurance information.
Effectively instructs patients with proper protocol in preparing for test ordered by the Physician.
Effectively answers patient's questions pertaining to test and procedures ordered by the physician.
Identifies correct patient in scheduling/registration system with Physician's office by verifying patient identifier's (SS#, DOB and Name) at the time of scheduling.
Verifies correct procedure at time of Scheduling/Indexing in order for correct patient and patient information to be on patients Medical Record chart.
Verifies signature, date and valid diagnosis on all orders.
Verifies insurance information by checking eligibility to ensure insurance information is active or inactive. Communicates with physician office to any insurance discrepancies.
Collects deductibles and co-pay/co-insurance and any other payment per hospital policies.
Understands the MSP questionnaire to determine appropriate primary insurance.
Understands and completes the MSP questionnaire to determine appropriate primary insurance at time of pre-registration or registration.
Screens for Medical Necessity using Care Medic or other Medical Necessity system and communicates with the physicians’ offices for needed information at time of Scheduling, Pre-registration and registration of patient.
Ask all pertinent questions concerning HIPAA regulations and enters information appropriately into system and distributes any information to patient.
Verifies any communication barriers at time of Scheduling with Physician offices/Patient and enters into system.
Ensures that the correct admitting physician is entered in the system.
Demonstrates the ability to be flexible and organized as well as functional under stressful conditions.
Notifies appropriate areas timely regarding add-on or STAT procedures.
Uses available resources to ensure correct exam is scheduled.
Reviews procedure's assigned scheduling instructions to ensure procedure is scheduled correctly.
Enters applicable notes in the scheduling system as appropriate.
Keys information into scheduling system an/or QCI in timely manner.
Enters appropriate notes on all accounts including authorization numbers/ notes in order for admission/ Case Management to view all pertinent information and all other documents in a timely manner.
Scans or indexes valid/complete orders, pre-certification/ authorizations information and all other documents in a timely manner.
Understands and completes estimated point of service forms.
Verifies pre certification process is complete and all accounts, notifying physician's office and patients of any denials/reschedules.
Corrects AHIQA in a timely manner and turns in report at the end of the day.
Completes all required projects/reports in a timely manner.
Works reports to make sure pre-certification information is completed in a timely manner .
Keeps abreast of all pertinent federal, state and facility regulations, laws and policies as they presently exist and as they change or are modified.
Understands and adheres to compliance standards as they appear in the Corporate Compliance Policy, Code of Conduct, and Conflicts of Interest Policy.
Demonstrates age-specific skills as required by position.
Offers suggestions on ways to improve operations of department and reduce costs.
Attends all mandatory education programs.
Improves self-knowledge through voluntarily attending continuing education/certification classes.
Maintains required competency levels as identified in written exams, skills checklists, skills labs, annual safety and health requirements as well as service excellence education hours requirements.
Willing to cross-train in order to better assist co-workers and to provide maximum efficiency in department.
Volunteers/participates on hospital committees, functions, and department projects.
Manages resources effectively.
Reports equipment in need of repair in order to extend life of equipment.
Makes good use of time so as to not create needless overtime.
EDUCATION:
* High School Diploma or Equivalent
COMPETENCIES & SKILLS:
* Takes personal responsibility for the quality and timeliness of work, and achieves results with little oversight.
Basic computer skills
Is reliable and trustworthy while performing work in a consistent and timely manner.
Earns others’ trust and respect through consistent honesty and transparency in all interactions.
Correctly interprets and follows instructions.
Healthcare procedure scheduling
Conveys ideas and facts orally using language the audience will best understand.
Phone skills
Resolves difficult or complicated challenges.
Helps create a work environment that embraces and appreciates diversity.
Conveys ideas and facts in writing using language the reader will best understand.
Southwell/Tift Regional Health System, Inc. is an Equal Opportunity Employer.