Patient Visit Specialist - Heart Group

Presbyterian Healthcare Services Albuquerque , NM 87102

Posted 2 weeks ago

Overview

Job Description Type of Opportunity: Full Time FTE: 1.000000 Exempt: No Work Schedule: Weekday Schedule Monday-Friday

Summary:
Performs visit closure activities to coordinate patient care while providing an exceptional patient experience for successful completion of next steps ordered by the clinician

Advanced scheduling for specialty or radiologic procedures

Recognizing payor requirements and obtaining prior authorization/certification/referrals for visits/procedures Processes daily referral workqueues for authorization, deferring only those that require payor consideration

Primary Care and most Specialty Care offices must process STAT and ASAP referral workqueues for results received

Return scheduling knowledge to include the ability to scrub schedules for accuracy and efficiency in home department

Monitor in-baskets and reports for overdue results, waitlisted appointments, recalls, etc

Responsibilities

Customer Service and Caring Practices:* Achieve exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools.

  • Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times

  • Ability to manage conflict and appropriately request the help of a supervisor when needed

  • Fosters effective patient relations with patients, the public and providers by listening, responding and escalating when appropriate

  • Round with patients waiting to insure their comfort and to inform of delays when applicable

Encounter Components:

  • Review and follows order entered into the EHR by the clinician

  • Schedule return visits lab, radiology, STAT & ASAP appointments and advanced imaging

  • Obtain Prior Authorization/Referral per payor protocols

  • Validates patient MyChart Access

  • Prints AVS as applicable with double check for HIPAA privacy

  • Collects any backend patient balance such as high deductible

  • Communicates effectively to ordering clinician when any restriction, such as access, restricts or prohibits scheduling as ordered

Financial Accountabilities:* Refers as appropriate to on site Financial Advocate, or for uninsured to the Financial Advocacy Center

  • Validate prior authorization/certification/referral are secured PRIOR to a scheduled procedure or test, alerting stake holders (patient, patient representative, OR, etc) if a breakdown occurs

Message Management:

  • Formulates complete and accurate telephone encounter messages and routes to the appropriate Epic in-basket pool to support operational aspects of patient care.Medical Record Components:

  • Instructs patients on the Release of Information process and insure a fully completed ROI Form is submitted to Health Information Management for incoming or outgoing records

Patient Relations

  • Comprehend quality service connection to patient satisfaction and reimbursement

  • Participate in metric goals for telephones performance metrics, TSF and abandonment rate when applicable

  • Perform confirmation calls when applicable to include directions and instructions as required by the visit type

Patient Safety

  • Respond quickly to patients showing distress. Follow guidelines set forth by the Clinic Manger to alert the clinical team. Assist in any manner the clinic team directs.

  • Ensure check out area, waiting area and walkways are clear of any unnecessary items and are clean and neat.

  • Report any concern that may create a safety issue.

  • Annual competency completion of Clerical Staff during a Code BlueQuality Improvement:

  • Appointment reminder calls

  • Rescheduling* Evaluate provider schedules and take appropriate action to ensure accuracy and efficiency per guidelines

  • Works with assigned physicians to maximize schedule effectivenessC.A.R.E.S Behaviors:

  • Demonstrates CARES behaviors of Collaborate, be Accountable, Respect, Engage and Serve to all whom you encounter.

Qualifications

  • Minimum 18 months experience in a medical office setting with significant MD interaction

  • Proficiency in prior authorization/certification/referral process

  • Must pass EPIC competency for Registration at completion of Epic Clerical Training class

Education:High School Diploma or GED

Benefits

Benefits are effective day-one (for .45 FTE and above) and include:

  • Competitive salaries

  • Full medical, dental and vision insurance

  • Flexible spending accounts (FSAs)

  • Free wellness programs

  • Paid time off (PTO)

  • Retirement plans, including matching employer contributions

  • Continuing education and career development opportunities

  • Life insurance and short/long term disability programs

About Us Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees.

Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans. We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come. About New Mexico New Mexico's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque's International Balloon Fiesta, Los Alamos' nuclear scientists, Roswell's visitors from outer space, and Santa Fe's artists, and you get an eclectic mix of people, places and experiences that make this state great. Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC. New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

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Patient Visit Specialist - Heart Group

Presbyterian Healthcare Services