Centralized Scheduling Rep

Shift: Day

Job Summary: Under the direction of the Centralized Scheduling Manager and the Director of Revenue Cycle the Centralized Scheduling Representative is responsible for accurately collecting, analyzing and recording the required demographic, insurance/financial and clinical data necessary to schedule, pre-register and register all types of patients to ensure that bills are produced according to regulatory and payer requirements; effectively completes all activities including medical necessity and managed care requirement screening, and third party eligibility and benefit verification to ensure maximum payer compliance is maintained and maximum reimbursement is secured; interacts in a customer-focused manner at points during the access and later activities as appropriate, to ensure that patient’s and their representatives’ needs are met, and that they understand and comply with the revenue cycle process expectations including resolving their personal liabilities through various payment and program options.

Demonstrates Competency in the Following General Areas:

• Commits to one hundred percent (100%) patient and customer satisfaction by always exhibiting a courteous and helpful manner during interactions with others, including patients, families, visitors, physicians and co-workers.
• Maintains a general, overall working knowledge of the department’s mission thereby having the ability to provide basic service and support to others, including patients, families, visitors, physicians and co-workers. Recognizes when others are in need of assistance and consistently offers to help when own workload permits.
• Fully knowledgeable of the comprehensive revenue cycle policies and procedural flow, and able to apply this knowledge to all situations.

Demonstrates Competency in the Following Primary Duties:

• Accurately collects and analyzes all required demographic, insurance/financial and clinical data elements necessary to schedule/register all types of patients by interviewing physicians and their office personnel, other referring providers, the patient and/or appropriate patient representative(s); receiving information via facsimile transmission, mail, previously recorded information, and all other available documents and forms such as insurance cards, etc.; and records and electronically enters the information on a timely basis.
• Provides appropriate information and explanations to patients and other appropriate parties regarding scheduled appointments, financial liability, Advance Beneficiary Notification, and other attestations as applicable.
• Initiates electronic and/or telephone inquiries to the appropriate party(ies) including third party payers, employers, and/or claims administrators sharing information as necessary in order to secure, record and electronically enter data which confirms the patient’s eligibility for third party benefits and the detailed level of benefits for the services being provided, as well as any other essential claim submission instructions that might be identified during this inquiry.
• Secures and witnesses all required signatures according to internal policy and regulation as applicable including Release of Information, Financial Assistance Application, Financial Agreement and other attestations as applicable; appropriately documents all activities to account to ensure that account history is maintained.
• Accurately scans all face sheets, insurance cards, ID cards and all other necessary registration/admission documents so that they can be permanently stored on optical disk.
• Provides information and explanations to the patient or responsible party regarding the policy and various options for resolving the calculated self pay liability for the service being provided.
• Accurately prepares, produces and distributes to other internal and external parties as appropriate and on a timely basis, required forms, reports, notifications and other applicable documents.
• Provides backup support to all patient care access areas including but not limited to Admissions, Centralized Scheduling and Financial Representatives.
• Provides training and support to all Level 1 Patient Access Representatives.
• Keeps Centralized Scheduling Manager and Director of Revenue Cycle informed of work activities, needs and problems.
• Performs job specific duties and all other duties as assigned in a timely and accurate manner.

Professional Requirements:

• Wears identification while on duty; meets dress code standards; appearance is neat and clean.
• Reports to work on time and as scheduled, uses time and attendance system correctly and completes work within designated time.
• Attends mandatory meetings; attends and/or reads minutes of other scheduled meetings.
• Respects patient confidentiality and uses discretion in discussion of patient information.
• Participates in continuing educational activities as deemed appropriate by department’s Manager or Director. Completes annual education requirements in a timely manner including but not limited to a minimum of 6 hours per year of job shadowing in the Patient Accounting and Admission area.
• Follows hospital and departmental requirements for infection control and safety.

Educational/Experience/Regulatory Requirements:

• High school diploma or equivalent required. Associate’s degree or active pursuit of Associate’s degree preferred.
• Must be able to pass pre-employment testing including but not limited to clerical ability and typing test.
• AAHAM or NAHAM certification or active pursuit of certification preferred.
• One-year previous acceptable experience in dealing with the public in a revenue cycle or scheduling environment required.
• Must be able to meet the public in a direct and professional manner.
• Previous work history that demonstrates steady attendance and punctuality is required.

Language Skills:

• Must be able to read & communicate effectively in English.
• Must be able to communicate firmly what is required of patients in regards to their financial status.
• Must be able to communicate (orally and in writing) effectively with patients, doctors and other departments in the institution.

Physical Demands:

• Work may be stressful with regular patient contact. Must be able to meet, communicate, and work with patients and public directly, orally, and in writing.
• For physical demands of position, including vision, hearing, repetitive motion and environment, see attached description. Near visual & hearing acuity required to perform essential duties of position.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising client care.