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BWPO Practice Assistant II, Orthopaedics

4 months ago

Coolidge Corner, United States Brigham & Women's Hospital(BWH) Full time

The Practice Assistant II is primarily responsible for appropriately greeting and welcoming all customers who visit the practice, including checking patients in and out, collecting appropriate co-payments in the practice management system, distributing necessary institutional and practice-specific forms, requesting that patients review and verify existing demographic and insurance information, setting certain expectations for patients regarding their visit, and responding to customers' information needs. Responsible for answering and appropriately managing incoming telephone calls, following up on phone messages, and triaging walk-in patients. The Practice Assistant II is responsible for monitoring patients in the waiting room and assisting in related patient flow processes. This position is responsible for performing various administrative and clerical duties required to support the practice, such as managing the scheduling referral work queue, and may be required to perform other tasks as assigned.


PRINCIPAL DUTIES AND RESPONSIBILITIES:

  • Performs all aspects of patient scheduling which includes entering complete information, booking appropriately the disposition of all appointments, confirming patient visits, and inputting necessary data. This includes booking of interpreters when needed.
  • Operates multi-line telephone consoles for ambulatory rehab department (PT, OT, SLP).
  • Screens calls and provides information to callers, records, and transmits messages, or directs call to triage therapist and/or appropriate individuals. Returns follow up calls as indicated.
  • Prepares, organizes, and distributes all appropriate patient reported outcome measures.
  • Correctly identifies issues related to insurance/registration and cordially directs patients when changes are indicated.
  • Appropriately identifies problems/opportunities that impact on clinical schedules and service availability to the triage supervisor.
  • Receives files and/or distributes incoming mail and insurance approvals.
  • Scans all department related forms including written physician referrals and Medicare Certifications into EPIC and manages MD reconciliation in EPIC.
  • Schedules appointments, utilizing the computer's clinical information scheduling option, for multiple ambulatory EPIC departments within Rehabilitation Services. Organizes schedule for multiple clinicians.
  • Maintains various lists and records such as triage and walk-in referrals and beeper numbers, as directed.
  • Organizes and maintains appropriate inventory of office supplies in the department.
  • Arrives, cancels, or no-shows all daily visits in EPIC.
  • Manages pre-scheduling program of post-op patients, research patients, and walk-ins.
  • Assists in training of new clinical and front desk staff in regard to scheduling and front desk duties.
  • Assists managed care coordinator with assigned tasks. Fills in for managed care coordinator in their absence.
  • Demonstrates effective interpersonal skills in all interactions with public, staff, patients and families and caregivers. Is always polite and courteous. Understands how to de-escalate tense situations and ask for assistance when needed.
  • Maintains all provider scheduling templates and adjusts in a timely fashion as needed.
  • Performs all check-out functions, including scheduling follow-up visits within the rehabilitation department.
  • Daily monitoring and execution of the eReferral work queue for their respective rehabilitation clinic. This includes scheduling referral appointments from the work queue. Also, work to ensure all the BWH expectations are met with scheduling referral appointments and linking referrals.
  • Provides support and information to patients and providers to problem solve and manage complex administrative and patient issues.
  • Maintains confidentiality and privacy, which is consistent with HIPAA/PHI guidelines.
  • Understands HMO, Managed Care, and other Third-Party Insurers.
  • Understands financial services and self-pay resources and provides patients with information as needed.
  • Works on special projects as directed.
  • Performs all other duties & tasks as assigned.

Additional Managed Care Duties:

  • Obtains and processes initial referrals and extension requests for Rehabilitation Services to minimize administrative impact on therapists and patients for managed care and workers compensation.
  • Maintains written logs to allow staff to check on referrals in process.
  • Works closely with all managed care plan representatives to process referrals quickly and to resolve problem referrals efficiently.
  • Works with patients around processing of referrals. Provides extensive patient education about managed care plans, referral process and plan benefits.
  • Maintains hospital computer based managed care system for referrals.
  • Participates in hospital committees involving managed care.
  • Works with specialist offices to resolve referral issues that arise.
  • Provides managed care support to other practice assistants and providers as required.
  • Often required to work very independently in referral problem resolution.
  • Works with supervisor to continually refine and streamline referral process.
  • Works with clinical supervisor to resolve monthly Insurance Rejections.
  • Maintains effective, timely communication with supervisor and staff to keep informed on all updates and/or changes in the managed care referral process.

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:


1. Work requires judgment and integrity in dealing with confidential materials.

2. Strong interpersonal skills necessary to deal effectively with a variety of professionals, staff, patients, and visitors.

3. Must have good oral and written communication skills.

4. For positions in our Boston location, fluent in Spanish preferred.

5. Complies with ambulatory standards and other regulatory agency standards (i.e. HIPPA) regarding interaction with the public.

  1. Knowledge of referral management and insurance parties. Ability to learn this content area if no prior experience.
  2. Excellent organizational skills.
  3. Ability to prioritize work in a very busy atmosphere, flexible and calm in changing high volume clinical setting.
  4. Familiarity in a Hospital setting preferred.
  5. Ability to independently problem-solve successfully.
  6. Capable to work quickly to resolve or minimize identified problems.