Patient Service Coordinator III

Wentworth-Douglass Hospital Boston , MA 02298

Posted 6 months ago

GENERAL SUMMARY/ OVERVIEW STATEMENT:

Practice Access Coordinator is responsible for ensuring prompt patient access to Allergy Associates. Must use excellent discretion and judgment and be proactive, effective and efficient in coordinating and managing clinician daily schedules. The Practice Access Coordinator will assist Department administration with the effective management of the practice's daily operations and revenue enhancement as well as identify and communicate to the practice's leadership issues of process creating inefficiencies with the daily operation.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Perform all duties and responsibilities of a PSC II and I.

Cross-trained in all clinic coordinator duties associated with the front desk, including but not limited to the following tasks: checks patients in for appointments, collects co-pays, handles insurance referrals, schedules future appointments, prepares daily schedules and patient paperwork, coordinates referrals to other departments and facilities, schedules imaging exams and handles any necessary insurance pre-certification, maintains the cleanliness of the waiting room and patient areas, handles patient needs as they arise in the daily clinic flow.

Cross-trained in all clinic coordinator duties associated with the back office, including but not limited to the following tasks: scans patient records, manages incoming and outgoing mail and faxes and sorts appropriately, provides phone line and voicemail coverage, appropriately triages patient care and prescription refill requests, processes necessary billing edits, keeps track of supplies and maintains cleanliness in the back office and supply closets, coordinates research studies as needed.

Utilizes MGH-provided software and web-based applications to coordinate appointments, messages and requests for Allergy patients.

Function as the unit Super User for Epic scheduling system

Displays professional & compassionate customer service skills.

Triages and manages complex telephone calls and in-office patient interactions effectively and courteously.

Provides information and supports problem-solving, troubleshooting, and managing complex patient situations.

Directs and assists patients in need of various resources to the appropriate MGH Departments.

As an important team member, works effectively with other Practice staff to manage workflow.

Identifies and communicates to Practice Leadership issues of process creating inefficiencies within the operation and assists in their resolution.

Provides cross-coverage for other Practice staff members as needed (e.g. staff absences, vacations, and during variations of workflow, etc.).

Do or arrange unit specific training for new hires, while coordinating with the practice-training mentor.

Assist in special projects, as required, may include, but not limited to projects, re: obligations to insurers, hospital issues of compliance and/or Operations Improvement Initiatives.

Learns and identifies complexities of various insurance plans and payers, including HMO plans, Managed Care, and other Third Party Insurers, as it relates to Allergy patients and payment issues (self-pays, co-pays, referrals, prior approvals, etc). Helps educate Allergy patients how to navigate coverage issues by referring to appropriate resources.

Develop and maintain a front desk training and orientation manual.

Act as back-up coverage for practice manager and front desk staff

Work with Practice Manager to develop new forms to streamline front desk workflow.

Assist with special projects as required.

Perform insurance eligibility using MGH software device.

Serves as a resource person for support staff

Assist in the orientation and training of new support staff members.

Understands managed care plans, HMO's and unusual coverage; calls Primary Care Physicians for

referrals; Runs insurance eligibility checks; and provides information to patients regarding eligibility for procedures.

Ensures that all front desk staff members understand insurance guidelines

Appraises patients of insurance eligibility

Handles fiscal procedures including, but not limited to: managed care procedures, patient billing problems, International patients and self-payer billing.

Consistently maintains confidentiality and privacy and all HIPPA guidelines.

QUALIFICATIONS:

High School diploma or GED equivalent required: Associate's Degree in Secretarial Science/Business, Secretarial Training Certificate Program, or Bachelor's Degree preferred.

Minimum of 2-3 years' work experience in health care / hospital setting, customer service or administrative office required.

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:

Demonstrated technical ability to learn various new software and web-based applications, and how to effectively interface between programs

Demonstrated ability to work independently and with a team

Strong attention to detail and organizational skills, and effective time management skills

High-level communicator with all levels of staff, physicians, nurses, and management, both in verbal and written communication

Demonstrates exceptional customer service skills or willingness to learn

Demonstrates knowledge of HIPAA Confidentiality and Privacy policies

Demonstrates an understanding of Disaster protocols to include: fire, safety, code calls, per the mandatory training, as outlined by MGH and JCAHO guidelines


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