Prenatal Pediatric Physicians Scheduler

Job Description - Prenatal Pediatric Physicians Scheduler (260000GN)

Job Description

Prenatal Pediatric Physicians Scheduler - ( 260000GN )

Schedules, pre-certifies, verifies and documents procedure and communication needs for Children's Hospital Prenatal Pediatrics Institute and DC Mother Baby Wellness Program. Works with parents, referring offices, and other CNMC departments to schedule patients in a timely manner. Assures that registrations and insurance information are correct, as well as obtain insurance referrals and pre-authorizations, as needed.

High School Diploma or GED (Required)

3 years progressive experience performing patient registration and scheduling, medical insurance verification and obtain authorizations, preferably in a physician's office as a receptionist or in a customer service environment. (Required)

Must be proficient in Cerner, Passport, Phreesia, Red Cap and other CNHS registration systems. Must be able to learn and become proficient in the MADAMS database system utilized by the Prenatal Pediatrics division. Excellent verbal, interpersonal, consumer relations and telephone skills required. Must answer all incoming calls and avoid messages going to voicemail. Must respond to phone calls promptly and with courtesy and respect.

Must have proficient knowledge of medical insurance verification process, experienced in obtaining insurance authorizations, insurance screen and financial counseling, billing and healthcare business operations, as well as working knowledge of CPT4/ICD9 coding. Must be able to multi-task and have knowledge of medical terminology.

• Process patient Pregnancy/Postpartum referrals of Care from Physicians, Nurse Practitioners and other community partners.
• Confirm and correct computer aided, on-line registration with parent/guardian via telephone or in person in courteous and consumer-orientated manner; collect personal and insurance information.
• Discuss co-payment, deposits or payment in full requirements with parents prior to scheduled appointment; counsel parent or refer parent to Medlaw for financial counseling or establishing payment schedule.
• Contact and verify insurance company in a timely manner to pre-certify procedure, document pre-certification notes in STAR registration system and MADAMS database; contact MFM’s for referrals and or H&P’s as needed.
• Coordinate appointments and/or procedures with other departments per patient needs; follow-up with each parent/patient until clinic visits are scheduled.

• Post detailed notes into MADAMS database utilizing the policy guidelines; maximize the Fetal Medicine Institute room block time utilization; confirm cases with the physicians and care coordinators.
• Contact system managers immediately when problems occur.

• Assure that a registration for the appointments and diagnostics are in Cerner, STAR, and MADAMS systems at least two days prior to date of procedure or clinic visit.
• Confirm with parent/guardian; facilitate consents for patients who are wards of the state/district.
• Confirm that there is a Consent, Pregnancy Plan of Care and History & physical form for patients; log in above information into MADAMS database retrieve any rescheduled patients’ from referral logs promptly, to ensure no delay on the day of service.
• Provide expertise and help to other schedulers.
• Share new insurance notifications and changes with the schedulers and managers.
• Immediately notify care team by email, of any cancellations and add-on cases.

• Speak up when team members appear to exhibit unsafe behavior or performance
• Continuously validate and verify information needed for decision making or documentation
• Stop in the face of uncertainty and takes time to resolve the situation
• Demonstrate accurate, clear and timely verbal and written communication
• Actively promote safety for patients, families, visitors and co-workers
• Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance