STCI-AMBULATORY SCHEDULING SPECIALIST

General Purpose of Job:

Under the direction of the STCI HIM Ambulatory Supervisor, the Ambulatory Scheduling Specialist's main objective is to schedule and/or pre-register patients for STCI. Responsibilities include scheduling patient appointments, providing pre-registration, verification of insurance, obtaining insurance authorizations, collecting patient payments and completing appropriate medical necessity checking.

Essential Duties:

This job description is intended to cover the minimum essential duties assigned on a regular basis. Caregivers may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

• Interview patients for the purpose of scheduling and/or pre-registration. Collect complete and accurate confidential demographic and financial information to comply with regulatory agencies and billing requirements.
• Assign appropriate ICD-10 for registration and billing compliance purposes at the point of scheduling and registration.
• Verify medical necessity check upon scheduling a patient.
• Verify insurance eligibility and covered benefits by using all electronic systems available or by phone.
• Answer telephones, direct calls and record and distribute messages.
• Schedule clinical office visits and appointments.
• Schedule appropriate patient testing prior to office visits.
• Reschedule appointments as needed.
• Monitor physician clinic schedule to ensure clinics are adequately scheduled to maximize patient access.
• Explain billing/payment policies to patients.
• Check-out patients, collecting payment as needed.
• Collect and verify necessary insurance authorizations as appropriate and possess knowledge of financial class requirements regarding registration and insurance requirements. Prior to arrival, document financial information in the accounts for billing purposes and to ensure benefits are listed for point of service collection.
• Collect payments for services that are not covered by the patient's insurance.
• Operate multiple computer applications to register patients, schedule appointments and retrieve surgical, testing, insurance and financial information.
• Communicate with providers (physicians, APPs, RNs) regarding orders placed for patients.
• Serve as a liaison between STCI Cardiology Lansing Clinic and other departments e.g. Patient Support Services, Patient Access, SMG Referring physician offices, all hospital emergency departments in order to obtain required data for appointments scheduled at STCI.
• Work exception accounts held internally or rejected by payers for errors related to registration an financial clearance activities.