Patient Serv. Coord. III- Waltham 40hrs

GENERAL SUMMARY/ OVERVIEW STATEMENT:

The Patient Services Coordinator III functions within the ambulatory practice as the department team leader coordinating administrative functions within the practice while assisting the department administration with the effective management of the practice's daily operations and revenue enhancement.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

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

Coordinates the scheduling of multiple specialty department appointments using multiple systems or resources.

Check-in / Check-out patients, answer/ triage phones, scheduling of appointments, prepares daily paperwork, faxing, responds to Patient Gateway messages, and populates and manages multiple provider schedules in Epic.

Conducts or arranges for unit specific training for new administrative hires, while coordinating with the practice-training mentor.

Manages all department Work queues and outside referrals that come into the Practice. Works with the Central Scheduling team to communicate updates, provider changes, workflow modifications. Attends meetings as necessary.

Works to ensure HIPAA Confidentiality and Privacy Policies is fully implemented.

Coordinates the workflow and schedules within the department to insure an efficient daily operation and troubleshoots workflow issues as needed.

Function as the department's "Super User" for EPIC CADENCE scheduling system including Template Building for provider schedules.

Identifies and communicates to the Practice's leadership issues of process creating inefficiencies within the operation. Assists in their resolution, working within the department and with management for the practice location.

Coordinates the workflow and schedules within the pod/unit to ensure an efficient daily operation. Troubleshoots workflow issues, as needed, problem solve and present new workflow ideas to management.

Assists with special projects as required. Projects may include such topics as obligations to insurers, hospital issues of compliance and/or Operations Improvement Initiatives.

Provides cross coverage for other Practice staff members for absences, vacations, etc. and during variations in workflow as needed.

Conducts or arranges for pod/unit specific training for new PSC hires, while coordinating with the practice-training mentor.

Resource and lead person for administrative staff when issues arise.

Performs Surgical Booking, which includes coordinating PATA and other necessary appointments.

Investigates and resolves issues relating to and arising from the referral and/or billing process, which interrupts the delivery of care to a patient or the reimbursement for services rendered. Addresses patient questions, complaints, and concerns.

Understands contracted verse non-contracted insurances, HMO, PPO, Medicare, Medicaid, self-pay, and other third-party insurers. Possesses a thorough knowledge of all HMO, managed care, other third-party insurers, and available patient financial services/resources.

Functions as a resource for patients and staff around managed care plans, insurance, and referral/prior authorization issues and possesses the ability to perform electronic insurance verification, using resources such as NEHEN and the payer gride.

Investigates and resolves issues relating to and arising from the referral and/or billing process, which interrupts the delivery of care to a patient or the reimbursement for services rendered. Addresses patient questions, complaints, and concerns. Works closely with Financial Staff for insurance requirements.

QUALIFICATIONS:

High School Diploma or GED.

Associate degree in Secretarial Science/Business, or a Secretarial Training Certificate Program preferred

Minimum of 3 years work experience in medical group practice, billing and/or managed care setting required.

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:

Demonstrated experience to interface with various levels of the practice with administration and clinicians.

Thorough knowledge of EPIC CADENCE system modules and its features, electronic medical record modules.

Demonstrated ability to work independently, with limited supervision, resolve issues, be organized, attentive to detail and achieve outcomes within the team.

Must possess excellent organizational and prioritizing skills with the ability to multitask.

Demonstrates effective interpersonal and communication skills.

Bilingual in English and another language a plus.

Ability to problem solve, work under pressure and under very tight deadlines.

Energetic team player with positive attitude.

Adequate typing skills (30WPM) and familiarity with computers (Microsoft Outlook, Word, Excel, internet).

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.