Service Center Coordinator

3 weeks ago

Littleton, United States Littleton Hospital Association Full time

**Position Summary**: The LRH Service Center employee will be responsible for functions within the areas of phone reception, patient scheduling, incoming and outgoing referral coordination. Each member of the Service Center will have assigned areas of responsibility, which may rotate, but will be responsible for all elements of the Service Center success through coordinated cross training and cross coverage of the center in order to ensure that all elements of service are met successfully by the care team. This will also encompass multi-practice knowledge, in all areas of scheduling, prior authorizations and referrals.

**Reports to**: Director of Patient Access and Central Services; Manager of Patient Access and Central Services

**Essential Functions**:

- Understands the important Littleton Regional Healthcare places on providing exemplary customer service, and performs job functions in a manner that is consistent with LRH processes and organizational customer service goals
- Responsible for the accurate collection of demographic and financial information in support of claims management, administrative and clinical activities of the hospital.
- Greets patients in a professional manner through respect and compassion
- Directs patients to appropriate destinations in the hospital and practices
- Works with department supervisor on issues related to personal work performance through ongoing education
- Attends and participates in department staff meetings as requested
- Adheres to department dress code policies at all times
- Maintains flexibility in work schedule availability that allows department to change/modify work schedules to meet department needs
- Meets federal, states and hospital requirements related to compliance issues
- Demonstrates a positive and professional approach, and communicates effectively with customers and team members at all times.

**Switchboard**:

- Responsible for receiving and processing calls from patients, physicians and all other parties seeking access to LRH practices, personnel and appointments with physicians and providers
- Refers calls through telephone encounters in EMR to nursing staff or providers as necessary. Appointments include but are not limited to Primary Care and Specialty Clinics.
- Verifies accuracy of patient demographic and insurance information, and updates patient information in the EMR

**Scheduling**:

- Responsible for scheduling patients at all LRH practice locations, including Specialty Clinics, in accordance with visit protocols specific to individual physicians and advanced practice providers.
- Records calls through telephone encounters in the EMR as necessary
- Verifies accuracy of patient demographic and insurance information, and updates patient information in the EMR when making appointments
- Monitors schedules for specialists assuring referral has been processed per outlined protocols
- Processes referral request to referral coordinator including required attachments per protocol
- Notifies patients of specialist appointments that have been made
- Request copies of films and tests as indicated per protocol
- Verifies insurance coverage for tests/procedures per protocol
- Handles all telephone calls in a timely, professional, courteous and helpful manner
- Enters telephone encounters into the EMR system and follows through as appropriate

**Referrals**:

- Responsible for processing incoming referrals for LRH physicians and providers
- Processes outgoing referrals for Primary Care and Specialty Clinics
- Creates new referrals in an accurate and timely manner
- Follows up on incomplete referrals using established protocols to ensure that patients are contacted and scheduled for visits
- Sends new patient packets to incoming referral patients, including appointment time, patient brochure and map
- All referrals should be processed within 48 hours of receipt
- High priority referrals should be processed within 4 hours of receipt during work hours
- Responsible for processing incoming LRH and non-LRH providers to LRH specialists; all outgoing LRH providers to LRH specialists or outside providers
- Service Center Coordinator must ensure that all elements are complete and information is present
- Service Center Coordinator will confirm insurance benefits and eligibility under patient insurance plan
- Service Center Coordinator will determine if a formal referral from the patients PCP is required
- Process prior authorization with help from clinical staff if needed
- Responsible for follow up on claims denials due to the referral process
- Responsible to change visit status to appropriate code and assign referral per established protocol, and ensure that PCP is notified

**Prior Authorizations**:

- Identifies all patients requiring pre-certification or pre-authorization at the time services are requested
- Determines insurance company eligibility and benefits for requested services
- Follows up with the patient, insurance company, or provider if

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