PRACTICE CRD 2

New Patient Scheduling and Processing

• Reviews and works referral workqueues, documenting activities within the referral record.
• Acts as the primary contact for referring physicians and new patients.
• Maintains electronic log for external referrals.
• Schedules and registers patients by telephone or in person before first appointment.
• Completes appropriate practice intake paperwork and ensures new patients are seen within prescribed time lines.
• Communicates any problems with the schedule with supervisor.
• Collections and verifies insurance and referral/authorization information for first appointment.
• Schedules and coordinates any pre-appointment tests or appointments.
• Explains first appointment procedures in layman’s terminology to patient.
• Provides practice-specific guidelines related to service/visit.
• Manages patient expectations by providing practice-specific guidelines.
• Works as a team member and maintains a professional and courteous demeanor.

Surgery Scheduling

• Coordinates scheduling of all outpatient and inpatient surgeries.
• Ensures that all surgical procedures are scheduled within a clinically appropriate time frame.
• Interacts with patients, physicians and hospital staff to ensure adequate communication regarding all aspects of surgical services.
• Coordinates surgical activities with physician’s other responsibilities.
• Processes complex hospital admission forms, schedules pre-surgical tests and appointments, and secures all necessary resources and equipment for surgery.
• Manages complex scheduling coordination related to securing OR time outside of designated block time in the operating rooms.
• Works to maximize both OR and surgical robots utilization as well as complex joint cases with one or more additional surgeons or other services.

Revenue Cycle

• Performs cash collection and depositing functions as assigned.
• Communicates Medical Center administrative and financial policies clearly to patients.
• Obtains and documents insurance authorizations for established patient visits, referrals and procedures or ancillary services.
• Communicates clinical information from medical records authorization requests to insurance companies.
• Demonstrates competency working with CPT codes and ICD-9 and ICD-10 for the purpose of scheduling and securing authorization.
• Works with patients and staff to confirm availability and accuracy of medical information within APeX and to ensure compliance with all hospital policies and procedures.
• Makes sure provider(s) open charts and encounters are completed in a timely manner to support revenue cycle workflow.
• May assist provider with instructions on how to close encounters opened in error.
• Works RFI workqueues to secure information for accurate billing submissions or to respond to denials such as retro authorizations, clinical documentation, and addended authorizations with add on CPT codes.
• Secures authorization for procedures, specialty visits and ancillary testing and coordinates with Hospital Admissions Department as needed.
• Provides assistance with complex DME authorizations that often require precise documentation in specific formats to receive approval.
• Provides assistance with medication authorization for new medications and refills.
• Monitors provider(s) open charts and encounters and works with providers to complete encounter documentation in a timely manner to support revenue cycle workflow.

Check in / Front Desk

• Greets and welcomes patients making eye contact and utilizing AIDET standards.
• Determines a patient’s co-pay obligation and collects it at the time of the visit.
• Maintains the reception area, making sure it is tidy and there is adequate availability of reading and educational materials.
• Maintains the temperature of the reception area and ensures there is adequate and appropriate seating for all patients.
• Observes the waiting area and performs customer service intervention when patients have been waiting a long time or are not receiving adequate service.
• Aids patients with use of Kiosk and actively works to promote Kiosk utilization.

Cadence Template Builder

• Able to create Cadence schedule templates for providers.
• Understands how template construction affects access and works to ensure templates is user friendly and helps promote consistent clinic access.
• Able to generate reschedule reports in Cadence and work with other members of administrative team to ensure patients are rescheduled in a timely manner to avoid customer service problems.

APeX and IT Specific Skills

• Performs the following APEX specific Patient Care Coordinator (PCC) functions as appropriate to completion of APeX PCC training and job duties:
• Enter new incoming referrals entering authorization information as appropriate.
• Update and close CRM messages and convert CRM messages into telephone encounters if practice is serviced by the Ambulatory Services Call Center.
• Open, document within, route and close telephone encounters.
• Able to accurately utilize documentation steps when leaving a telephone encounter open pending further communications with the caller.
• Able to utilize smart text logic to document patient phone screening as associated with complex appointment scheduling.
• Works applicable APeX workqueues to address patient care and service matters.
• Create and send administrative communications via MyChart.
• Create SmartPhrase templates associated with administrative functions.
• Create and route patient letters associated with administrative matters.
• Encourage use of the check in kiosk and trouble shoot technical or customer service issues.
• Pend orders (including med refills, referrals, procedures etc.) associate with a diagnosis and route to provider for review and signature (from preference list only).
• Pend Smart Sets with proper orders and diagnosis and route to provider for review and signature.
• Modify order class of labs from lab collection vs. clinico-diagnostic.