Pt Access Scheduler - Wound Clinic

Overview

Summary:

Serves as first point of contact for customers of TMC Health Care; initiates the entry point for requested healthcare services and revenue management. Responsible for computerized patient registration and scheduling as well as insurance verification to include validation of authorizations and/or benefits information for ancillary procedures. Maintains and fosters effective public relations with patients and visitors.

Essential Functions:

Exhibits excellence in customer service through appropriate attitude and interaction with all patients, visitors and staff; adheres to and supports team members in exhibiting TMCH values of integrity, community, compassion, and dedication.

• Collects deposits or deductibles and advises patient or guarantor of insurance benefits and anticipated cost estimates; ensures that cash handling follows corporate policies.
• Ensures completion of financial documentation in accordance with TMCH’s credit and collection policies.
• Explains all necessary compliance forms and obtains patient signature as required for regulatory agencies.
• Performs medical necessity screening and ensures compliance with system requirements.
• Assists outpatient departments with minor system maintenance, to include closing resources, opening resources, performing overbook and override as requested.
• Interacts with physicians and/or physicians’ office staff to secure diagnosis, procedure details or authorization information as needed.
• Communicates with Medical Records and Professional Staff Services as necessary.
• Uses medical terminology and scheduling knowledge to select correct procedure when scheduling and coordinates information with other departments as needed.
• Demonstrates knowledge of resources, staffing, instrumentation, and equipment specific to procedures to avoid scheduling conflicts.
• Performs patient registration activities to ensure accurate financial and biographical data and documentation have been obtained and properly entered into hospital records.
• Completes insurance processing; including account creation, insurance verification, notification, and authorization functions.
• Communicates with departments/physicians for special requests, emergent cases, overbooking and add-ons; informs management about issues/problems with tools/times.
• Handles incoming telephone calls and exercises judgment in scheduling caller for correct procedure in appropriate service area; receives telephone requests to schedule from patients, physicians, physician office staff, employers, and hospital personnel, if applicable.
• Explains procedure preparations to patients so they are properly prepared before arriving at the hospital as needed.
• Documents all notification, authorization and eligibility information in the registration systems, uses electronic verification tools and web-based resources.
• Adheres to TMCH organizational and department-specific safety, confidentiality, values policies and standards.
• Reconciles daily cash drawer.
• May prepare and reconcile daily deposits.
• Performs related duties as assigned.

EDUCATION: High School diploma or General Education Degree (GED), completion of vocational medical office training desired, or an equivalent combination of relevant education and experience.

EXPERIENCE: Two (2) years of medical office and/or hospital experience to include six months healthcare eligibility and benefit analysis or scheduling experience for diagnostic testing and/or surgery.

LICENSURE OR CERTIFICATION: Heartsaver CPR (HSCPR or HSFACPR) certification required within ninety (90) days of employment for Pediatric Therapies and Adult Therapies departments only.

• Knowledge of office management practices, including billing and scheduling within healthcare.
• Ability to read or listen and comprehend simple instructions, short correspondence, and memos.
• Ability to write simple correspondence; ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
• Ability to read and interpret documents such as safety rules, procedure manuals, and governmental regulations.
• Ability to effectively present information and respond to inquiries or complaints from patients and/or their representatives and the general public.
• Ability to interpret and explain insurance benefits and patient financial responsibility.
• Ability to apply common sense understanding to carry out simple/detailed written or oral instructions.
• Applicants must have basic computer familiarity and experience and the ability to operate basic office equipment.

• Entry level

• Full-time

• Health Care Provider
• Hospitals and Health Care