Outpatient Services Rep

About the role

Under the general supervision of, but according to established policies and procedures, the incumbent performs various administrative duties to expedite each patient's visit for clinical care. These duties include preparation of patient records; registration and pre-registration activities; problem resolution; appointment scheduling; and co-payment preparation and collection. Ancillary duties provide tracking and status of follow-up care as it pertains to specific diagnostic coding, billing/payment resolution, and generation of system reports reflecting scheduling activities.

Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide everyday actions with patients, customers, and one another. All employees are also expected to demonstrate the core Success Factors: Instill Trust, Value Differences, Patient and Community Focus, and Collaborate.

Responsibilities

• Schedules patients using the hospital's scheduling system, including appointment type, specific provider clinic, and appointment time.
• Schedules follow-up appointments using the online scheduling system; may schedule appointments for lab work, diagnostic imaging, or referrals to other medical providers.
• Refers technical or clinical inquiries to appropriate personnel.
• Uses the online billing system to enter diagnosis/service codes from encounter sheets, ensuring accurate code entry.
• Completes pre-registration and registration using the online billing system, verifying demographic data, insurance authorization, co-pays, and physician information.
• Collects co-payments and provides patients with receipts; produces registration cards using the online system and card embosser.
• Photocopies front and back of insurance cards and confirms patient eligibility with insurance carriers, obtaining visit authorizations as necessary.
• Provides mature, quality customer service to patients, families, and representatives.
• Mails informational material to new patients in advance of scheduled appointments.
• Contacts external agencies to obtain patient information and coordinate clinic/treatment programs; contacts third-party payors for pre-authorizations.
• Acts as an outpatient center receptionist, including making appointment reminder calls, answering incoming calls, returning calls to patients and providers, and greeting arriving patients.
• Orients patients to the specific outpatient center as a hospital-based service and interacts effectively with patients and family members.
• Handles coding/billing within department guidelines, verifying appropriateness of diagnostic codes and resolving billing issues with patients and Patient Financial Services.
• Refers patients to patient advocate for financial counseling as needed.
• Obtains and organizes medical records for physicians and nurses; ensures patient files are complete prior to treatment, including lab results and x-rays.
• Prints reports using online scheduling and billing systems.
• May respond to telephone inquiries by rotating into a centralized call room setting.
• Utilizes Epic for scheduling and registration and Cedaron for patient documentation.
• Obtains authorizations and tracks insurance plan frequency rules and benefit limits accurately and timely.
• Effectively multitasks scheduling appointments while answering phones and checking in/out patients of Rehabilitation Services.
• Uses knowledge of patient diagnosis to triage and schedule patients with appropriate clinical therapists.
• Schedules patients with multiple appointments across disciplines such as Physical Therapy, Occupational Therapy, Speech-Language Pathology, and Aquatic Therapy.
• Scans documents into Epic and manages work queue for registration errors.

Minimum Qualifications

• High School Diploma or equivalent.
• Demonstrated PC skills using the Windows operating system and software packages.
• Knowledge of medical billing routines for physician office practice.
• Knowledge of medical terminology, diagnosis codes, and procedure codes.
• Proficiency in courteous telephone technique and good customer service skills.
• Six months of experience coding and billing using an online billing system.

Work Environment and Physical Requirements

• Walking, sitting, and standing throughout the day in a clinic setting.