Patient Services Coordinator
4 weeks ago
The Patient Services Coordinator plays a vital role in ensuring seamless healthcare experiences for patients. This dynamic individual will serve as a liaison between referral sources, clinical services teams, physicians, and patients to address healthcare needs. With a focus on timely, accurate, and courteous service, the Patient Services Coordinator will troubleshoot problems efficiently and use discretion to involve the manager when necessary.
Key Responsibilities- Patient Advocacy: Provide a favorable first impression and proactive attention to internal and external customers to meet or exceed expectations, address concerns, and optimize experience.
- Service Recovery: Take ownership of problems that may arise and resolve them using appropriate rationale.
- Patient Rights and Responsibilities: Provide patients with and interpret patient rights and responsibilities.
- Scheduling and Coordination: Interact with patients and collaborate with providers and clinicians to schedule appointments considering scheduling guidelines, resource availability, special needs, timeframes, medical necessity, and payer and contractual guidelines.
- Insurance Verification: Obtain and document pertinent insurance verification information to avoid denials and ensure financial reimbursement.
- Financial Clearance: Obtain and/or verify that all demographic, financial, and insurance coverage information is accurate, up to date, and complete, and that financial clearance has been obtained inclusive of all required referrals/authorizations.
- Benefit and Authorization Requirements: Provide patient/guarantor with detailed benefit and authorization requirements and co-pay, deductible, and co-insurance self-pay responsibility.
- Charge and Fee Explanation: Explain charges, fees, and previous balances for both technical and professional components.
- Collection and Reconciliation: Reconcile all collections and transactions at the end of the shift, including initial cash funds, and determine upon checkout/discharge any pending financial responsibility and collect and post payment(s) accordingly.
- Quality Assurance: Comply with all standard operating procedures established to support key metrics and quality assurance initiatives that contribute toward prompt billing and increased cash flow.
- Systematic Warning Flags: Identify systematic warning flags/messages and populate required data elements to eliminate bypassed warnings/errors and avoid a negative impact on downstream revenue cycle processes.
- Patient Work Queues: Monitor and clear patient work queues on a daily basis to ensure data integrity, prompt billing, and minimal AR days.
- Charge Code Entry: Enter charge codes and number of units accurately and within (1) business day of services being rendered.
- Daily Reconciliation: Perform daily reconciliation to identify missing charges and follow up with providers to obtain in order to ensure all rendered services are accounted for and billed.
- DAR Review: Review DAR and identify appointments that are not in completed status.
- Education: High School Graduate or General Education Degree (GED). Bachelor's degree in relevant discipline highly preferred.
- Certificates & Licenses: None required.
- Experience: 5+ years of experience in a healthcare setting required.
- Medical Knowledge: Working knowledge of medical symptoms, signs, and anatomical systems to identify and differentiate type and urgency of medical need.
- Insurance Knowledge: Knowledge of insurance referral requirements to ensure access based on third-party reimbursement criteria.
- Communication Skills: Excellent verbal and written communications skills in English. Bi-Lingual (English/Spanish, English/Polish, English/French, English/Arabic) a plus.
- Critical Thinking and Problem-Solving: Must possess excellent, critical thinking, analytical, troubleshooting, problem resolution, and customer service skills.
- Mathematical and Cash Management Skills: Excellent mathematical and cash management skills.
- Interpersonal Skills: Excellent interpersonal skills and ability to work effectively with physicians, co-workers, other departments, and patients of all ages, and from across a broad range of cultural and social economic backgrounds.
- Teamwork and Adaptability: Ability to work as an integral team member under minimal supervision, in a fast-paced, complex environment.
- Confidentiality and HIPAA: Ability to show tolerance and sensitivity in stressful situations and safeguard confidential information in accordance with established policies and HIPAA laws.
- Computer Skills: Computer literate and ability to use multiple systems and acquire proficiency in multiple electronic systems.
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