Responsible for interacting with patients, payers and providers to gather and manage information necessary for programmatic qualifications, accurate registration including assigning of appropriate Medical Record Number, scheduling/re-scheduling, referral/authorization, point of service payment collection, document collection and arrival/check-in functions. Receives and routes messages in the department appropriately as well as manages customer billing and payment inquires as needed. Effectively manages the patient check-in and check-out process from start to finish, which includes identification verification; updating or confirming demographic and insurance information on every patient; ensuring appropriate forms are provided, signed and witnessed at the time of the patient visit; verifying coverage including benefits, authorization, pre-determination, payer specific policy exclusions or limitations to coverage, collecting any patient responsibility and accurately preparing end of day reporting or payment reconciliation as needed. Assisting patients with HPE eligibility, discussing payment arrangement options including financial assistance information, providing price estimates. Responsible for accurately scheduling and re-scheduling patient appointments based on program qualifications. Successful scheduling includes, but not limited to, exhibiting proficiency in appointment scheduling procedures, accurate documentation and routing of messages, scheduling and confirming appointments according to practice guidelines, entering appropriate insurance, initiating authorizations and referrals; in and out of network, performing Key User duties with minimal errors. May coordinate scheduling, meeting and travel planning needs, department communication as needed for programmatic support. May assist in gathering necessary reports, statistics, outcomes for the department as needed and is also a liaison to other programs. Responsible for tracking the scheduling and completion of programmatic studies. Regularly displays a proactive approach to customer service by listening to the patient, taking ownership of solutions and is able to accurately identify the need to involve leadership in order to resolve concerns. When working on program and/or patient care unit, acts as a part of the patient care team by supporting the clinical care staff in the care of the patient. Maintains electronic calendar for assigned faculty/administrator using appropriate software; generates daily printed calendar; makes, changes, and cancels appointments as required; provides up-to-date information and reminders, to ensure meetings and commitments are not missed. Completes and submits accurate and timely leave forms to ensure documents are approved prior to date of leave; tracks and posts extra-mural leave for assigned provider, in accordance with institution and department policies and procedures. Updates and maintains databases within the department, related to the programs. Checks and distributes documents/correspondences appropriately. Reviews files and records to answer requests for additional information. Creates and maintains desk manual, to inform temporary or backup support in times of unexpected absence, and to facilitate cross-training within the department.
Experience/Specialized Skills: : Must be able to demonstrate proficiency of computer applications, excellent mathematical skills and ability to handle monies. Excellent communication and customer service skills. Strong organizational and analytical skills; innovative with ability to identify and solve problems. Able to adapt, prioritize and meet deadlines.
Required Education/Course(s)/Training:
Preferred Education/Experience/Specialized Skills/Certification: 2 years experience customer service or healthcare/medical office environment. Knowledge of medical terminology, commercial and government health insurance and billing guidelines, ACA requirements, understanding of DRG's, Medical ICD9/ICD10 codes and CPT/HCPC Codes and Modifiers.
Job: *Business Office
Organization: *Scripps Mercy Chula Vista
Title: *PATIENT SERVICE SPECIALIST *
Location: Southern San Diego County-CHULA VISTA-SCRIPPS MERCY HOSPITAL CHULA VISTA
Requisition ID: 242005721