Scheduler

 Coffee Regional Medical Center

Scheduler 

 POSITION SUMMARY

•Responsible for scheduling patients for surgery, pre-admission testing and diagnostic testing by telephone contact and verifying insurance benefits prior to patients’ arrival.

•Responsible for communicating authorization information to Pre-registration Financial Counselors, via Paragon system.

 OVERVIEW

•The evaluation is to assure individual performance, departmental goals and organizational goals are aligned. It is designed to support communication between the manager and the employee. Employee perception of their own performance is very important. To maximize the benefit of this process, both the manager and the employee participate in the evaluation process.

QUALIFICATIONS

A.Knowledge, Skills and Abilities

•Excellent customer service skills.

•Reads and understands the English language.

•Ability to think critically and analytically with little or no supervision

•Ability to work effectively in situations of high stress and conflict and communicate goals and outcomes.

•Ability to process information and prioritize

•Possesses exceptional verbal and written communication skills

•Possesses independent work habits, is self-reliant and self-directed

•Ability to learn, adapt, and change as required by the job functions

•Ability to maintain absolute confidentiality of material and information accessed and reviewed

•Basic computer literacy

•Ability to move freely, reach, bend, and complete light lifting

•Ability to use good body mechanics while performing daily job functions and ability to follow specific OSHA guidelines

•Ability to maintain attendance to meet standard job practices

B.Education

•High School Graduate or G.E.D. required.

•Vocational or Technical College certificate preferred.

C.Licensure

•N/A

D.Experience

•Minimum of one year experience required in medical field.

•Pre-certification or billing experience preferred.

•Computer and typing skills must be above average.

•Must be able to use number key pad for keying numeric entries.

•Knowledge of medical terminology helpful.

E.Interpersonal skills

F.Essential technical/motor skills

G.Essential physical requirements

•Sedentary: Exert up to 10 lb. of force occasionally and/or a minute amount frequently - > 75%

H.Essential mental requirements

I.Essential sensory requirements

J.Other

•Basic understanding of Medicaid, Medicare and Commercial Insurance guidelines.

•Analytical and organizational skills must be above average.

•Attention to detail, communication, and documentation skills must be excellent.

•Prior public relation experience is required.

•Operations of computer systems and business machinery also required.

•Must have the ability to communicate with patients in a courteous manner and possess excellent telephone communication skills with the ability to remain calm in difficult situations.

•Must have the ability to talk with public in a professional manner and be able to interpret patient charges and explain in detail.

•Must have excellent interpersonal communication skills and possess professional and neat appearance.

K.Equipment used

 OTHER QUALIFICATIONS

A.Exposure to hazards (body fluid exposure level)

•Level III

B.Age of Patient Populations Served

•Adolescents 13 - 18 years

•Adults 19 - 70 years

•Geriatrics - 70+ years

 JOB SPECIFIC DUTIES AND PERFORMANCE STANDARDS

•Below are those tasks, duties, and responsibilities that comprise the means of accomplishing the position’s purpose and objectives. These are critical or fundamental to the performance of the position. They are the major functions for which the person in the position is held accountable. Following are the essential functions of the position, along with the corresponding performance standards.

oMajor Task, Duties, and Responsibilities

Be committed to the Standards of Performance, CRMC's and Financial Counseling Mission and Vision statements.

Responsible and accountable for tasks necessary to properly identify patient, create an account for the patient, with accurate insurance information. Maintain acceptable accuracy rate.

Responsible for scheduling patients by telephone contact with physician office and/or patient when case sheet is received in the appropriate information system, and verifying insurance benefits through use of internet, automated voice response and other integrated systems, prior to the patients arrival for scheduled testing.

Determines primary insurance liability in cases requiring coordination of benefits (spouse, dependent child) and obtain necessary prior authorization information.

Notifies physician office of any potential delay or change in testing schedule. Ensure all physician orders meet current standards and policies. Obtain clarification on unclear or inappropriate orders.

Continues to stay informed of any policy or regulation changes that could affect collection of receivables. Updating personal manual with current revisions of policies, review Communication Board, and attend all staff meetings and in-services as required.

Review schedule prior to pre-registration of patient to ensure prior authorization has been obtained.

Answer telephone professionally, courteously and maintains a high degree of patient confidentiality. Answers all inquiries in a courteous and timely manner. Use the scripting policies as a guide to effective communication with customers.

Refer uninsured patients to the Upfront Financial Advisor for counseling prior to scheduling.

Responsible for assisting with development, implementation, and education of staff for new systems. Responsible for implementation and maintenance of new/existing software programs.

Complies with all established hospital and departmental policies and procedures to include but not limited to attendance, dress code and safety.

Understands the significance of the organization's Performance Improvement Programs and is an active participant.

Reports any problems to immediate supervisor daily as needed.

Provide excellent customer service to all patients and family members and promote a positive image of CRMC. Communicate the mission, ethics and goals of CRMC.

Maintains a high degree of patient confidentiality in accordance with HIPPA regulations.

Responsible for any and all other functions as required and directed by Supervisor.

 

Check fax machine frequently during day for incoming orders and distribute to areas.

Check fax in-queue and move orders to appropriate account.

Check phone messages at least hourly.

oAbility to produce workable ideas and techniques, willingness to attempt new approaches and perform job duties independently.

Performs duties in an independent manner with minimal direct supervision.

Can solve day to day problems within scope of practice and make decisions in a timely manner.

Offers workable ideas, concepts and techniques to improve productivity.

Willing to attempt new job duties, tasks, etc.

Maintains regulatory requirements including all state, federal and Joint Commission regulations related to Patient Access and, as appropriate, to the facility.

Performs any other task as requested by Supervisor or Management in a willing and positive manner.