Reports to the Manager/Director and works under the direction of the Office Supervisor. Under general supervision and according to established policies and procedures. Responsibilities include Receptionist duties as well as scheduling specialty and/or diagnostic procedures, knowledge of ICD-10, CPT and online Authorizations. Assists in coordinating healthcare services to a large outpatient client population. Verifies insurance eligibility when appropriate for the physician office and/or member.
MISSION, VALUES and SERVICE GOALS
- MISSION: We deliver outstanding care, inspire health, and connect with heart.
- VALUES: Trust. Respect. Integrity. Compassion.
- SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.
Performs routine reception and clerical duties in accordance with established policies and procedures by:
- Receiving and greeting patients and visitors and checking in patients for their appointments.
- Receiving telephone calls, taking and relaying messages accurately.
- Obtaining information from the patient to accurately complete the patient record for payment information, computer input, etc.
- Maintaining patient files, charts, and records.
- Maintaining good rapport and cooperative working relationship with all members of the medical offices, other medical offices, hospital services, and community agencies.
- Maintaining technological competencies, organization, and neatness in the work area.
- Completing all mandatory in-services in required time frame.
- Assisting co-workers as needed.
- Acting as liaison between provider offices, physicians, health plans and other departments to ensure high-quality customer service are being delivered.
Performs Referral duties in accordance with established policies and procedures by:
- Performing online insurance eligibility/authorizations, and scheduling diagnostic/specialty referrals.
- Resolving re-certification, registration and case-related concerns prior to a patient's appointment
- Gathering pertinent information from insurance carriers, financial counselors, and other ancillary staff to make certain the patient's financial obligations for services provided.
- Providing support to clinical staff in order to facilitate the administrative components of clinical referrals for various services.
- Acting as a liaison between hospitals, physicians, health plans, vendors, and patients, or other referral sources.
- Verifying insurance coverage and obtains authorizations if needed from insurance coverage.
- Entering referrals and documents communications, actions, and other data in an information system
- Evaluating current processes for enhancement and make necessary recommendations.
Patient care duties, as directed by the physician or nurse, by:
- Interpreting physician's instructions to patients and providing instruction to patients.
- May schedule imaging and diagnostic procedures.
Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department.
- Attending required meetings and participating in committees as requested.
- Enhancing professional growth and development through in-service meetings and educational programs as approved.
- Completing other job-related duties and projects as assigned.
ORGANIZATIONAL RESPONSIBILITIES
Associate complies with the following organizational requirements:
- Attends and participates in department meetings and is accountable for all information shared.
- Completes mandatory education, annual competencies and department specific education within established timeframes.
- Completes annual employee health requirements within established timeframes.
- Maintains license/certification, registration in good standing throughout fiscal year.
- Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
- Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
- Adheres to regulatory agency requirements, survey process and compliance.
- Complies with established organization and department policies.
- Available to work overtime in addition to working additional or other shifts and schedules when required.
Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:
- Leverage innovation everywhere.
- Cultivate human talent.
- Embrace performance improvement.
- Build greatness through accountability.
- Use information to improve and advance.
- Communicate clearly and continuously.
Education and Experience
- The knowledge, skills and abilities as indicated are normally acquired through the successful completion of a high school diploma or equivalent; Previous medical office experience, ICD-10, CPT, online insurance eligibility/authorizations, and specialty/diagnostic referral experience preferred.
Knowledge & Skills
- Demonstrates well developed communication skills to communicate effectively and clearly to a variety of internal and external contacts.
- Knowledgeable in ICD-10, CPT, online insurance eligibility/authorizations, and scheduling diagnostic/specialty referrals.
- Knowledge of Allscripts, Cerner, referral database, excel, word, outlook, and net learning.
- Knows and adheres to all laws and regulations pertaining to patient health, safety and medical information.
- Demonstrates analytical skills necessary to solve patient problems and interpret data.
- Promotes collaboration and innovation in the clinical services to ensure an interdisciplinary approach to improving health care delivery and the quality of patient care.
- Must be tactful in handling patient problems often of a highly personal and confidential nature.
- Must be able to maintain professionalism during frustrating interpersonal situations.
Working Conditions
- Assigned hours within your shift, starting time, or days of work are subject to change based on departmental and/or organizational needed.
- May need to travel to other Beacon locations.
- Understands and strives for providing excellent customer service.
- Ability to adjust communication skills to the level of the patient.
- Works under direct supervision, but requires independent critical thinking skills and extensive problem solving skills.
Physical Demands
- Requires the physical ability and stamina to perform the essential functions of the position.
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