Central Scheduling Specialist

2 weeks ago

Lawrenceville, United States Penn Medicine Full time

**Description**

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Summary:

- Under the general direction of the Central Scheduling Manager, the Central Scheduling Specialist, performs standardized and consistent processes for procedure scheduling through the use of a central scheduling system that will allow for efficiencies.
- Responsible for scheduling, pre-registration, pre-authorization and patient/physician office communication prior to patient visit.
- Acts as patients/customers first point of contact when calling into the departments central line.
- Speaks with patients/callers using clear and professional language, and proactively resolve patient concerns/issues.
- Strictly adheres to scheduling guidelines and clinical protocols during all patient interactions. Obtains demographic and insurance information for accurate patient accounts.
- Verifies insurance eligibility, identifies patients in need of financial counseling, and secures patient accounts prior to the scheduled date of service.
- Responsible for adding HAR to patient account
- Responsible for transcribing orders, coordinating and scheduling appointments.

**Responsibilities**:

- Appointment Scheduling and Pre-Registration
- Answers inbound telephone calls in a professional, timely and efficient manner per department protocol. Identifies themselves at the beginning of each call. Demonstrates understanding and ownership of how his/her role contributes to achieving the success of the department and the Health system. Accurately completes patient-registration for new Penn Medicine Princeton Health patients. Reviews and verifies patient demographics for NJDDCS compliance. Determines reason for patient visit and possesses and utilizes knowledge of provider’s schedule and protocols as well as scheduling guidelines to schedule accurate and complete general appointment special appointment and emergency appointments. Exercises independent judgment to triage clinical issues to the provider or designee to determine appropriate scheduling action. Follows all prescribed PennChart searches, including 3-3 search and screening for any other Date of Service appointments. Coordinates patient appointments with other providers and departments and links appointments when required within PennChart. Coordinates clinical and administrative aspects of the new patient scheduling encounter including the provision and dissemination of information to the patient/customer as needed or required. Gives patients information on preparations needed for tests, scans; directs patients to the locations where the tests are performed. Maintains appointment blocks and availabilities in Cadence. Provides accurate patient information to the practice. Enters data into appropriate fields within appropriate system (s). Works with Clinical staff to confirm and expedite scheduling of services
- Insurance Verification and Medical Necessity - Ensures all necessary referrals, authorizations and/or pre-certifications are in place prior to patient's scheduled appointment. Utilizes scheduling system to prioritize workload based on service, date, and insurance company requirements. Utilizes on-line verification system(s) or places phone call to insurance company to ensure that all necessary referrals, authorizations and/or pre-certifications are in place. Initiates updates to established pre-certification if warranted by clinical exam validation. Communicates all necessary information to patient, physician, or responsible party regarding authorization requirements.
- Educational Development
- Must pass and stay current will all Penn Medicine Princeton Health educational requirements. Keeps current on CPT/HCPCS coding methodologies to accurately identify procedure codes needing authorization. Maintains working knowledge of PHCS insurance verification tools, including insurance guideline templates. Understands ICD-10 coding methodologies to accurately identify diagnosis codes to support medical necessity. Maintains working knowledge of Medical Necessity requirements for commercial and governmental payors.
- Interdepartmental Revenue Cycle Development
- Develops and maintains excellent working, professional relationships with external physician office staff and hospital personnel utilizing the services.
- Develops and maintains excellent working, professional relationships across all PHCS department lines served.
- Promotes teamwork both internally and externally.
- Works in collaboration wit

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