Schedule, pre-certifies, verify and documents procedure for Children's Hospital Operating Room and Ambulatory Surgery Center as well as outside
hospitals and surgery centers for patients. Work with parents and other departments to schedule patients in a timely manner assuring that registrations
and insurance information are correct. Verify guardianship/custody issues that might arise.
High School Diploma or GED
Minimum Work Experience
Specific Requirements and Preferences
Progressive experience performing patient registration and scheduling, medical insurance verification, preferably in a physician's office as a receptionist or in a customer service environment. (Required)
Must be proficient in CNHS HBOC, ORSOS and PPM/PSM systems.
Excellent verbal, interpersonal, consumer relations and telephone skills required.
Must have proficient knowledge in medical insurance verification procedures, insurance screening 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 .
Patient Service Activities - Registration and Scheduling
1.Process patient Surgical Plan of Care from Physician.
2.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.
3.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.
4.Contact and verify insurance company in a timely manner to pre-certify procedure, document pre-certification notes in HBOC registration; contact PCP's for referrals and or H&P's as needed.
5.Schedule various diagnostic tests using SCI system; call parent/guardian to schedule procedure, work with both the surgeon's and parent's schedules, as well as, possibly other physician's schedules for joint procedures; schedule patients for an appointment with physician, nurse or technical personnel using the on-line scheduling system (PSM); send parent a confirmation letter of procedure as well as other information relating to the surgical experience.
6.Coordinate admission and/or procedure with other departments per patient needs; follow-up with each parent/patient until procedure is scheduled.
ORSOS System Management
1.Post case in ORSOS utilizing the policy guidelines; maximize operating room block time utilization; confirm cases with the OR Posting Office.
2.Contact and receive authorization numbers for late rooms, use of open OR time, etc.
3.Contact system managers immediately when problems occur.
Confirmation of Procedure
1.Assure that a registration for the procedure is in the HBOC system at least two days prior to date of procedure.
2.Confirm with parent/guardian; facilitate consents for patients who are wards of the state/district.
3.Confirm that there is a Consent, Surgical Plan of Care and History & physical form for patients; log in above forms for placement in a binder in the Anesthesia Department; retrieve any rescheduled patients' forms and places in current binder , to ensure no delay on the day of service.
1.Provide expertise and help to other schedulers.
2.Share new insurance notifications and changes with the schedulers and managers.
3.Notify AMSAC, the posting office and P ACU nurses of any cancellations and add-on cases.
1.Speak up when team members appear to exhibit unsafe behavior or performance
2.Continuously validate and verify information needed for decision making or documentation
3.Stop in the face of uncertainty and takes time to resolve the situation
4.Demonstrate accurate, clear and timely verbal and written communication
5.Actively promote safety for patients, families, visitors and co-workers
6.Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance
1.Assumes responsibility for all aspects of the patients' procedures; follows up with scheduling, pending authorizations, registrations and any other possible patient needs even when other departments are involved with the care of the patient.
2.Pays attention to detail throughout the surgical scheduling process.
3.Perform routine Quality Control to ensure accuracy in scheduling.
1.Partner in the mission and upholds the core principles of the organization
2.Committed to diversity and recognizes value of cultural ethnic differences
3.Demonstrate personal and professional integrity
4.Maintain confidentiality at all times
1.Anticipate and responds to customer needs; follows up until needs are met
1.Demonstrate collaborative and respectful behavior
2.Partner with all team members to achieve goals
3.Receptive to others' ideas and opinions
1.Contribute to a positive work environment
2.Demonstrate flexibility and willingness to change
3.Identify opportunities to improve clinical and administrative processes
4.Make appropriate decisions, using sound judgment
Cost Management/Financial Responsibility
1.Use resources efficiently
2.Search for less costly ways of doing things
Children's National Medical Center