Clinical Service Specialist/ Menopause Clinic/ Full Time/ Days

About the role

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Schedule

40 hours/week Monday–Friday. Monday–Wednesday hours typically 0800–1700. Thursday–Friday hours typically 0730–1630.

Location

Lancaster, PA – Suburban Outpatient Pavilion – Menopause Clinic

Responsibilities

• Provides complete and accurate patient scheduling, registration, insurance verification, ordering of tests and coordination of applicable screening, diagnostic, physician office and outpatient hospital services.
• Coordinates and communicates effectively during increased volumes or with complex patients.
• Assists with the delivery of direct, non-licensed patient care in accordance with established methods and procedures, under the supervision and guidance of appropriate personnel.

Registration

• Performs complete and accurate patient registration including walk-in, check-in, and scheduled visits.
• Adapts and performs successfully during times of high volumes or high patient acuity.
• Services both hospital and physician office patients as needed.
• Supports inbound and outbound calls to or from patients, guests, or appropriate parties.

Patient Liability and Point of Service Collections

• Understands and supports Point of Service Collections.
• Performs all necessary functions to collect patient obligations.
• Refers patients to appropriate personnel for questions regarding collections, insurance coverage, and financial assistance.
• Disseminates or discusses information with patients regarding co-pays, out-of-pocket expenses, pre-appointment preparation, and arrival times.

E-Health Record Verification

• Verifies patient, guarantor, coverage and hospital account information.
• Performs required referral authorization processes and enters orders for applicable tests.
• Understands insurance company coverage and referral authorization requirements of payors.
• Performs electronic and manual verification of insurance coverage and accurately applies electronic insurance responses.
• Prepares and/or releases records or orders in the e-Health record; scans all necessary documents into the appropriate medical record.
• Sends all pertinent information to document imaging or health information management team within established time frames.

Compliance & Regulatory

• Completes documentation for compliance and regulatory needs and/or release of orders.
• Retains knowledge and abides by all regulatory requirements pertaining to position duties and overall operation of the hospital.

Complex Situations and Scheduling

• Screens and accurately relays messages using protocols established for emergent, urgent and non-urgent calls.
• Registers unscheduled patients requiring a full financial clearance.
• Completes assigned patient scheduling and registration work queues according to performance standards.
• Resolves work queue issues and missing registration items via electronic medical record.

Environmental Management

• Completes cleaning tasks utilizing OSHA standards.
• Performs maintenance and/or inventory of equipment and supplies according to unit/department standards.
• Maintains appearance of patient care and public areas.

Supply Management

• Orders, stocks and distributes supplies to meet the needs of the unit/department.
• Is aware of cost containment practices and able to assess need for changes in utilization.

Patient Care Safety

• Greets and escorts patients and visitors to and from clinic exam rooms; prepares patients for visits with providers.
• Initiates patient visits and follows up after visits when appropriate within scope and competency, following established standards.
• Prepares and assists providers with various procedures within scope and competency, following established guidelines.
• Maintains clinical skills necessary to perform job duties.
• Performs clinical functions as required, including any of the following: phlebotomy, pain management, EKGs, Holter monitors, 24-hour blood pressure monitoring, and point-of-care testing if needed based on departmental needs.

Secondary Duties

• May require regular travel to various sites within the region to support operational needs.
• Performs other duties as assigned.

Requirements

• High school diploma or equivalent.
• Completion of educational requirements with additional formal education/training; maximum supervision for initial competency; high degree of associated risk factors; yearly competency evaluation and training.
• One year of prior experience in Revenue Cycle in a hospital medical office setting and/or one year of administrative data entry experience in a medical facility, health insurance, or business setting.
• One year of clerical, customer service, or administrative support experience in a highly customer-oriented organization.
• One year of experience with basic keyboarding, personal computer use, and other office equipment.
• Health care provider in good standing with Medicare, Medicaid, and other federal and state health insurance programs (i.e., not excluded from participation).

Preferred Qualifications

• One year of Epic or equivalent Electronic Medical Record experience.
• One year of registration experience, point-of-service collection, insurance validation, understanding of compliance regulatory guidelines, and order release processes.