PHYS SERVICES SCHEDULER

Job Details

Description

Location/Department: Ortho - MMPC

Benefits Eligible - part time 64 hours per pay period

Job Summary

Insuring accurate selection of the patient & their demographic, employment & insurance data. Timely scheduling of patients while allowing for proper resource utilization such as room, equipment, technologist, physician, etc. Ensuring correct diagnosis/coding on patient order while meeting medical necessity determinations for payment & determining any pre-certification requirements are obtained correctly & accurately prior to the testing.

Supervisory Responsibilities: None

Duties/Responsibilities

• Determine 2 forms of identification for each patient prior to scheduling.
• Update all demographic data, employment data & insurance data at the time of scheduling.
• Provide patient care by rooming patients, assisting with procedures as needed, & completing chart assignments when working in the back office setting.
• Insure valid physician order by date & diagnosis.
• Work directly with office physician and staff
• Perform clerical functions of answering phone calls & scheduling appointments
• Communicate & coordinate with vendors
• Provide patients with surgery packet & review educational material
• Review perioperative requirements including pre-op labs & clearance, physical therapy, post-op appts, etc.
• Rotate between front & back office, assisting with patient care as needed
• Run medical necessity software against obtained data for allowance & compliance.
• Determine pre-certification requirements & obtain accurate data from physician office.
• Validate pre-certification data with insurance carrier to insure facility payment.
• Coordination of surgery scheduling with the corresponding departments as applicable.
• Maintains changes in testing protocols by working with department managers & staff.
• Maintains scheduling changes for preventative maintenances (PM), equipment downtime.
• Phones patients to remind them of scheduled appointments day prior to appointment.
• Reviews all prep instructions & responds to patient concerns & questions.
• Provides cost of test & expected out-of-pocket expense to patient.
• Notifies physician office when contacted by Business Office of claim denial relating to medical necessity & pre-certification denials.
• Develops appeal plan with physician office within 2 days of denial per carrier contract language.
  
  

Required Skills/Abilities

• Strong communication & customer service skills.
• Able to multi-task, problem solve, & complete tasks in a timely manner.
• Able to operate a computer & other basic office equipment.