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Central Scheduling Specialist

4 months ago

Lawrence Twp, United States Pennsylvania Medicine Full time

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 with other departmental associates as well as other hospital associates supporting their efforts through teamwork and the acceptance of additional assignments
  • Accepts responsibility for own actions, while taking ownership of departmental outcomes.
  • Maintains a strong working relationship with physicians and departments that the central scheduling team services, to ensure maximum communication and coordination of service.
  • Performance Improvement
  • Supports the entire Central Scheduling Department and Performance Improvement goals of the Department.
  • Collaborates with other staff, within and outside the Department, to develop means of enhancing patient care and service.
  • Collaborates with the Patient Financial Services Team to increase cash by decreasing denials.
  • Performs all other duties as assigned
Education or Equivalent Experience:
  • H.S. Diploma/GED
  • High school diploma or equivalent. Associate degree preferred. Knowledge of government reimbursement and commercial/managed care insurance regulations. Minimum two years hospital or physician office registration and scheduling or medically related call center. Maintains all training required for PennChart Certification
  • Other
  • Coding or Medical Terminology certificate preferred.

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.