PAS Pre-Encounter Scheduling Rep I

Job Summary The Pre-Encounter Scheduling Representative (Rep) I is the basic level of the Pre-Encounter Scheduling (PE) Services career path.
The PE Scheduling Rep I performs pre-encounter functions as outlined below: The PE Scheduling Rep I performs outpatient scheduling, registration, and insurance verification functions.
The PE Scheduling Rep I may perform these functions as needed or via dedicated rotation schedules.
Provides general and specific information to hospital users, patients, families and physician offices.
Ensures that patients meet financial requirements.
Provides excellent patient focused customer service.
Communicates effectively to service delivery areas insuring maximized patient flow and customer service.
The PE Scheduling Rep works at an entry-level and is required to master required competencies listed below: Outpatient Registration Outpatient Scheduling Outpatient Pre-Registration Insurance Verification Pre-Encounter Collections PRIMARY RESPONSIBILITIES PERFORMANCE STANDARDS SECTION I – COMPETENCIES: Schedules all patients for clinic appointments and services Manages time effectively to schedule patient appointments while meeting departmental productivity standards.
Uses time to complete other departmental duties when patients cannot be registered.
Maintains competencies in scheduling patients on all hospital scheduling systems.
Maintains response times within hospital average expectations for telephone answer times, talk times, and dropped calls.
Complies with all scheduling system notices, alerts and prompts.
Provides instructions to prepare patients with financial requirements due at check in.
Avoids double-booking appointments unless instructed by supervisory staff.
Reschedules and cancels patient appointments as required.
Prepares and mails patient itineraries or notices as required.
Advises patients about MyChart and assists with set up.
Performs complete and accurate pre-registration and pre-admission functions to provide information which maximize reimbursement, achieve collection ratios, meet account receivable (AR) goals, and provide timely and through information to all other providers and users of patient data.
Verifies insurance requirements, obtains and understands insurance benefits.
Requests non-covered fees.
Secures treatment authorizations as applicable to the services.
Manages time effectively to perform complete scheduling, demographic and insurance information, Uses time to complete other departmental duties and workques when patients are not being scheduled.
Maintains high attention to detail by reviewing all work for completeness and accuracy.
Completes scheduling and registrations to meet department accuracy standards for error-free work.
Exceeds Performance Standards Weekly accuracy rate of 99% - 100% error-free work.
Meets Performance Standards Weekly accuracy rate of 97% - 98% error-free work.
Performs departmental administrative functions as required.
Answers incoming telephone calls to meet all departmental areas according to departmental telephone standards.
(See Telephone Standard Policy) Completes departmental intake forms and shift/day end reports fully and accurately.
Organizes and files departmental audit/source documents.
Organizes and files department supplies.
Ensures that financial protocols and requirements are met while providing caring access to service at the MCHS.
Minimizes 3rd party payer denials by verifying authorization of service prior to notifying patients of their financial obligations.
Maintains competencies to verify insurance using electronic systems and web-based system as well as telephone verification.
When assigned, notifies patients of insurance benefits and self-pay financial obligations including previous balances.
Maintains current knowledge of insurance requirements communicated by email, memorandum, educational matrices and in-services.
Seeks assistance from MCHS Patient Access Registration Unit when needed to maintain patient call flow while resolving financial issues.
Communicates effectively with service delivery areas when unresolved financial issues may threaten appointment schedules.
Maintains a professional appearance.
Maintains a neat, uncluttered work area.
Posts worksheets, cheat-sheets and tools in appropriate files, flipcharts and bulletin board.
Keeps walls, desks and work surfaces clear and uncluttered.
Follows the hospital’s Dress Code policy.
SECTION II – CUSTOMER SERVICE: Maintains standards of service excellence by following AIDET.
Provides and promotes a professional, positive climate within the workplace.
A Acknowledge I Introduce D Duration E Explanation T Thank you Respects the rights and dignity of all patients.
Provides and maintains patient privacy at all times.
Is compliant with HIPAA guidelines and privacy practices, patient confidentiality and patient rights.
Makes eye contact, smiles and greets each customer/employee immediately.
Uses the customer’s/employee’s name whenever possible.
Escorts customer/employees to their requested location when possible.
Immediately approaches a customer or employee who seems lost and offers assistance.
Responds quickly by explaining any delays in service, even if it is not your department.
Follows up on requests, even when it is not a responsibility of your department.
Never say “I don’t know”; say, “I will find out.
” Acts and dresses professional in public areas at all times.
Stands erect and avoids leaning against walls and furniture.
Takes ownership of a customer’s problem.
Ensure the matter is resolved timely and that the customer is satisfied with the solution.
In closing, please respond by saying, “Is there anything else I can do for you, I have the time.
” Knows the services of McKenzie Health and the location of facilities and departments.
Respects the customer’s privacy and guard the confidentiality of all customer information Remembers that poor work quality is the same as poor customer service for every customer/employee.
Strives for excellence in everything that we do Keeps the Patient Access Services department spotless.
If something is out of place, picks it up.
SECTION III – CORE VALUES: Demonstrates personal responsibilities and maintains technical proficiency.
Functions as a team member to organize and prioritize responsibilities to complete daily work requirements: Complies with changes in duties and assignments in a positive and cooperative manner.
Adjusts to peaks in workload: demonstrates flexibility and adaptability to change.
Completes assignments in appropriate time frames.
Offers assistance to co-workers to ensure completion of all assigned duties as necessary.
Performs duties in a self-directed manner with minimal supervision or direction.
Performs other duties as assigned or required.
Demonstrates a positive, supportive, respectful and helpful attitude in interactions with all department customers (patients, physicians, visitors and other healthcare team members.
Offers and acts on constructive feedback.
Maintains a calm, professional manner.
Contributes to cohesive group relationships; uses open communication to identify and resolve problems in and between departments.
Refrains from gossiping.
Makes suggestions for improvements to procedures or innovations to enhance patient service.
Participates in interdepartmental or intradepartmental performance improvement teams as directed.
Demonstrates responsibility for own growth and development.
Updates knowledge to maintain departmental core competencies.
Attends and participates in 70% all departmental staff meetings.
Responsible for reading and reviewing departmental notes when not in attendance.
Reports to work appropriately groomed and in compliance with the hospital and department dress code.
Wears identification badge while on duty so that the employee badge are visible at all times.
Adheres to all hospital policies and procedures with regard to attendance and punctuality.
Unscheduled absence does not exceed hospital guidelines.
Provides notification for absences, lateness and vacation requests according to hospital guidelines.
Attend required training courses and complete all required competencies.
VII.
Physical Requirements: Physical requirements are primarily related to the essential functions of any job.
In order to perform the essential functions of this position, you must be able to Sit, Walk, Stand, Use your hands, Reach, Talk, and Hear.
Must be able to lift or exert energy up to 10 pounds 75 % of the time and up to 25 pounds 25% of the time.
Close vision is required, distance or clear vision at 20 ft.
or more and the ability to observe an area that can be seen to move up and down or left and right.
VIII.
Mental Requirements: Must possess the ability to read, analyze and interpret clinical or business account information, financial and legal documents.
Must have the ability to respond to sensitive inquiries or complaints from guests, regulatory agencies, staff and members of the business community.
Must possess the ability to write persuasive correspondence.
Must possess the ability to define problems, collect data, establish facts, and draw valid conclusions.
Must have the ability to deal with concrete and abstract concepts and interpret verbal, nonverbal and written instructions.
IX.
Age Competencies: This position primarily interacts with adolescents, adults and aging adults, does not provides direct patient care.
All staff members must be able to demonstrate the knowledge and skill necessary to meet the physical, psycho/social, educational, safety, and related needs of the persons in the assigned work area.
Minimum Qualifications: High school diploma or equivalent required.
Previous experience in relevant field preferred.
To perform this job successfully, an individual must demonstrate competence in each essential duty.
The requirements listed below are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
A minimum of 1 years’ experience in healthcare or customer service setting is preferred.
Clear, effective communication skills Skills in using PC computers and computer applications Detail orientation Knowledge of medical terminology Provides excellent customer service