Surgery Center Service Re

Summary

The Surgery Center Service Representative is responsible for scheduling and registering outpatient diagnostic testing and/or surgical procedures, supporting the general operation of the department, and remaining flexible at all times. This position provides services for pre-registration, payer authorization, registration services, pre and point of service collections, medical necessity checking and financial counseling, referring those patients to appropriate sources for follow up as needed. Customer service is an essential element of the position, as the employee will be responsible for assisting physicians, patients, visitors, and hospital staff with their needs as they relate to the functions of the department.

Essential Duties And Responsibilities

These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned.

Registration

Manages registrations for patients for the CRSCVB; meets patient access scorecard standards by registering patients in<= 10 minutes maintaining a wait time of<= 10 minutes when applicable

Interviews and accurately collects patient information and demographics; meets patient access scorecard standards by meeting accuracy rate as defined in annual goals and ensuring accuracy in medical record selection

Uses knowledge to verify, review, and coordinate benefits on behalf of patients; meets Patient Access Scorecard expectations for insurance verification rate

Manages payments at point of service, conducts cash receipting, and posts payments; point of service collection expectations are on the patient access scorecard

Assists patients with financial clearance of accounts by communicating financial responsibility through estimates, setting up payment plans, and/or providing referrals to financial counselors

Manages accounts in order to meet Patient Access Scorecard standards of productivity

In addition to daily account authorization reviews; identifies high risk admissions/registrations and obtains complete necessary authorizations and notifications of admissions from patients; meets patient access scorecard standards by reducing denial rates

Assists with training of new staff as well as shares departmental knowledge and provides assistive training with teammates

Manages scanning for the patients' medical record as required

Compiles, reviews, and manages weekly and monthly electronic reports as assigned by manager; makes financial edits preventing billing of accounts, corrects addresses or other demographic data for patients, or manages errors for other staff in order to successfully clear accounts

Provides courteous service to all stakeholders (patients, patient families, teammates, other department staff, etc.) by resolving stakeholder problems, responding to inquiries, and following-up in order to develop and strengthen customer relationships and maintain effective interdepartmental communication. Level of service and demonstrated patient commitment are connected to the patient access scorecard, the patient satisfaction scorecard and patient access department policies

Complies with governmental regulations in reference to healthcare, billing, the Health Insurance Portability and Accountability Act (HIPAA) and patient access department policies and procedures .

Demonstrates knowledge of ICD coding requirements and other billing rules

Promotes continuous process and quality improvement processes by .sharing and providing ideas and solutions to teammates, supervisors, and attending staff meetings; maintains educational requirements, and participates in new learning opportunities

Explores learning opportunities for professional development and growth of self, patient access department and CRMC by participating in professional organizations, participating in interdepartmental committees and projects, and conducting teach-backs to staff

Demonstrates an awareness of appropriate confidentiality rules and regulations and acts accordingly

Actively participates in service recovery and customer service activities to ensure a superior customer contact

Other duties as assigned

Scheduling

• Obtain detailed information to include: type of surgery, equipment needed, anesthesia requested, and preoperative testing required by surgeon
• Coordinate schedules with the Operating Room to ensure no lapses of productivity for center or the surgeon .
• Maintain accountability for scheduling surgery in an efficient manner to ensure surgeon productivity
• Coordinate continuity of care with programmatic coordinators
• Communicate with all coordinators, staff, insurance companies, and physicians regarding changes in schedule and/or patient status
• Phone triage patients for multiple conditions, and route them to the appropriate program
• Serve on committees and assist other team members as requested by the supervisor
• Maintain communication with the supervisor at least once a week to review financial performance targets as well as other projects defined by the Director
• Enter all surgery scheduling into the practice's management system
• Attend all required orientations, meetings, and in-services
• Demonstrate a commitment to flexible work scheduling when necessary to ensure patient care
  
  

Operations/Workflow

• Greet patients and visitors to the Center
• Answer telephones
• Update patient information
• Print face sheets and labels
• Obtains required signatures on proper paperwork
• Is knowledgeable of various insurance plans and can explain benefits clearly to a patient
• Is effective in asking for appropriate co-payments and deductibles; this is demonstrated by a high collection rate
• Post payments and balance daily batch
• Is aware of the different opportunities available to patients for financial arrangements/programs
  
  

Supervisory Responsibilities

Reports to: CRSCVB Clinical Director

May be provided direction by Clinical Coordinator or Surgery Center Service Representative Lead Supervises: None

Responsibilities: Not applicable

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the

Essential Functions.

Education and Experience

Minimum Required Education: High school diploma or equivalent required.

Preferred Education: Knowledge of medical terminology and ICD preferred. Associate degree in a health care field preferred (Health Information Technology, Medical Assistant, etc.)

Experience: Proficient and accurate data entry, typing skills. One year of current hospital or medical office experience required.

Certificates, Licenses, Registrations

Certification as Medical Assistant, Nursing Assistant, Emergency Medical Technician, or Paramedic preferred. Certified Healthcare Access Associate (CHAA), Certified Professional Coder (CPC) or other HFMA, NAHAM or AAHAM recognized revenue cycle certification required within 12 months in position.

Competencies

To perform the job successfully, an individual should demonstrate the following competencies:

Continuous Learning - Assesses own strengths and weaknesses; seeks feedback to improve performance; pursues training and development opportunities; strives to continuously build knowledge and skills; shares expertise with others.

Job Knowledge - Competent in required job skills and knowledge; exhibits ability to learn and apply new skills; keeps abreast of current developments; requires minimal supervision; displays understanding of how job relates to others; uses resources effectively.

Use of Technology - Demonstrates required skills; adapts to

• new technologies; troubleshoots technological problems; uses technology to increase productivity; keeps technical skills up to date.
  
  

Problem Solving - Identifies and resolves problems in a timely manner; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics.

Customer Service - Responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments.

Communications - Exhibits good listening and comprehension; keeps others adequately informed; selects and uses appropriate communication methods.

Cooperation - Establishes and maintains effective relations; exhibits tact and consideration; offers assistance and support to co-workers; works cooperatively in group situations; works actively to resolve conflicts.

Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions.

Teamwork - Balances team and individual responsibilities; exhibits objectivity and openness to others' views; gives and welcomes feedback; contributes to building a positive team spirit; puts success of team

• above own interests; able to build morale and group commitments to goals and objectives; supports everyone's efforts to succeed.
  
  

Quality Management - Looks for ways to improve and promote quality; demonstrates accuracy and thoroughness.

Conflict Resolution - Encourages open communications; confronts difficult situations; maintains objectivity; keeps emotions under control; uses negotiation skills to resolve conflicts.

Cost Consciousness - Works within approved budget; contributes to profits and revenue; conserves organizational resources.

Diversity - Demonstrates knowledge of EEO policy; shows respect and sensitivity for cultural differences; educates others on the value of diversity; promotes a harassment-free environment; builds a diverse workforce.

Ethics - Treats people with respect; keeps commitments; inspires the trust of others; works with integrity and principles; upholds organizational values.

Organizational Support - Follows policies and procedures; completes administrative tasks correctly and on time; supports organization's goals and values; benefits organization through outside activities; supports affirmative action and respects diversity.

Adaptability - Adapts to changes in the work environment; manages competing demands; changes approach or method to best fit the situation; able to deal with frequent change, delays, or unexpected events.

Achievement Focus - Sets and achieves challenging goals; demonstrates persistence and overcomes obstacles; measures self against standard of excellence; recognizes and acts on opportunities; takes calculated risks to accomplish goals.

Personal Appearance - Dresses appropriately for position; keeps self well groomed.

Attendance/Punctuality - Is consistently at work and on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time.

Dependability - Follows instructions, responds to management direction; takes responsibility for own actions; keeps commitments; commits to long hours of work when necessary to reach goals. Completes tasks on time or notifies appropriate person with an alternate plan.

Initiative - Volunteers readily; undertakes self-development activities; seeks increased responsibilities; takes independent actions and calculated risks; looks for and takes advantage of opportunities; asks for and offers help when needed.

Innovation - Displays original thinking and creativity; meets challenges with resourcefulness; generates suggestions for improving work; develops innovative approaches and ideas; presents ideas and information in a manner that gets others' attention.

Judgment - Displays willingness to make decisions; exhibits sound and accurate judgment; supports and explains reasoning for decisions; includes appropriate people in decision-making process; makes timely decisions.

Planning/Organizing - Prioritizes and plans work activities; uses time efficiently

Quality - Demonstrates accuracy and thoroughness; looks for ways to improve and promote quality; applies feedback to improve performance; monitors own work to ensure quality.

Quantity - Meets productivity standards; completes work in timely manner; strives to increase productivity; works quickly.

Safety and Security - Observes safety and security procedures; determines appropriate action beyond guidelines; reports potentially unsafe conditions; uses equipment and materials properly.