Scheduling and Preauth Coord

Job Requirements

Under general supervision, performs scheduling, pre-authorization and administrative activities for patients. Ensures the accurate registration of patients, interviews patients to obtain necessary demographic and insurance information to determine patients’ financial status.

Principal Responsibilities And Tasks

The following statements are intended to describe the general nature and level of work being performed by people to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

• Schedules patients for admissions, evaluations, re-evaluations and treatment in accordance with physicians’ schedules, managed care contracts and UMMS policies and procedures. Accepts referrals from social workers, discharge planners, physicians and physicians' offices. Schedules outpatient tests and procedures required.
• Obtains and inputs pre-authorization insurance and demographic information into the appropriate medical/scheduling system. Verifies patient benefits and eligibility prior to completing referral.
• Reminds patients of upcoming appointments, changes to schedules, co-payments required, and pertinent insurance information.
• Provides patients, family members and referral sources with information pertaining hospital policies and procedures, programs available and locations.
• Coordinates patient transfers from other local hospitals to UMMC; responsible for locating hospital beds.
  
  

Qualifications

Education and Experience

• High School Diploma or equivalent (GED) is required.
• Three years work experience in an administrative or clerical position in a health care setting such as an acute care hospital, nursing home or Health Maintenance Organization performing relevant clerical activities.
  
  

Knowledge, Skills And Abilities

• Demonstrated knowledge of various insurance coverage (i.e. Medicaid, HMOs).
• Highly effective verbal, written and interpersonal skills to effectively communicate hospital policies and procedures to medical staff, colleagues, patients and/or visitors, complete admission and/or other documentation and respond promptly to instructions given.
• Effective listening skills with the ability to listen and understand patient information and translate it to written documentation.
• PC Literate, with ability to enter and/or retrieve demographic, financial, and/or patient information on an online registration system.
• Ability to establishes and maintain courteous and effective relationships that foster quality customer service, and demonstrate sensitivity and awareness of customer needs; when dealing with patients/visitors, co-workers and healthcare staff.
• Ability to use resourcefulness and problem-solving skills when handling telephone and in-person inquiries or when required to resolve patient scheduling issues.
• Ability to work independently and respond effectively under stress.
• Ability to prioritize and manage numerous tasks in different stages of completion.
• Ability to observe and apply relevant hospital and departmental policies and procedures. Observe patient right to privacy in handling personal information in compliance with the Privacy Rule (under Title II of the Act) of the Health Insurance Portability and Accountability Act (HIPAA), ensuring the security and privacy of each patient’s health care information.
• Ability to demonstrate knowledge and skills necessary to provide care appropriate to the patient population(s) served. Ability to demonstrate knowledge of the principles of growth and development over the life span and ability to assess data reflective of the patient's requirements relative to his or her population-specific and age specific needs.
  
  

Patient Safety

Ensures patient safety in the performance of job functions and through participation in hospital, department or unit patient safety initiatives.

• Takes action to correct observed risks to patient safety.
• Reports adverse events and near misses to appropriate management authority.
• Identifies possible risks in processes, procedures, devices and communicates the same to those in charge.
  
  

Work Experience

Knowledge, Skills and Abilities

• Demonstrated knowledge of various insurance coverage (i.e. Medicaid, HMOs).
• Highly effective verbal, written and interpersonal skills to effectively communicate hospital policies and procedures to medical staff, colleagues, patients and/or visitors, complete admission and/or other documentation and respond promptly to instructions given.
• Effective listening skills with the ability to listen and understand patient information and translate it to written documentation.
• PC Literate, with ability to enter and/or retrieve demographic, financial, and/or patient information on an online registration system.
• Ability to establishes and maintain courteous and effective relationships that foster quality customer service, and demonstrate sensitivity and awareness of customer needs; when dealing with patients/visitors, co-workers and healthcare staff.
• Ability to use resourcefulness and problem-solving skills when handling telephone and in-person inquiries or when required to resolve patient scheduling issues.
• Ability to work independently and respond effectively under stress.
• Ability to prioritize and manage numerous tasks in different stages of completion.
• Ability to observe and apply relevant hospital and departmental policies and procedures. Observe patient right to privacy in handling personal information in compliance with the Privacy Rule (under Title II of the Act) of the Health Insurance Portability and Accountability Act (HIPAA), ensuring the security and privacy of each patient’s health care information.
• Ability to demonstrate knowledge and skills necessary to provide care appropriate to the patient population(s) served. Ability to demonstrate knowledge of the principles of growth and development over the life span and ability to assess data reflective of the patient's requirements relative to his or her population-specific and age specific needs