Senior Patient Services Coordinator

About the Role

Performs advanced Patient Service Coordinator functions and serves as a resource for other business office staff. May train entry-level business office staff. Carries out all duties while maintaining compliance, confidentiality, and promoting the mission and philosophy of the organization.

Responsibilities

• Performs all tasks of the Patient Service Coordinator as needed or assigned.
• Assists other Business Office staff with front desk duties, including but not limited to:
  • Answering phones
  • Booking appointments
  • Greeting patients
  • Check-in/check-out
  • End of day processing and documentation, including deposit
• Performs full patient registration functions, including collecting and entering all patient insurance and demographic information necessary to set up insurance coverage and patient accounts.
• Generates and processes referrals and authorizations.
• Responsible for opening the front office and all associated duties.
• Responsible for end-of-day processing and documentation, including deposit.
• Assists with the initiation of prior authorizations for medications.
• Verifies scheduling accuracy of MyChart appointments.
• Researches and resolves problems with patient accounts in work queues.
• Processes claim denial adjustments to patient accounts.
• Audits tickets in work queue for missed charges, completeness, and accurate coding using reports.
• Performs charge entry functions.
• Communicates with providers regarding coding issues.
• Serves as a resource for other Business Office staff.
• Assists with training of entry-level Business Office staff.
• Adheres to all company policies, including OSHA, HIPAA, compliance, and Code of Conduct.
• Regular and dependable attendance.
• Must be trained and provide backup coverage in one or more of the following duties:
  • CBO Site Requests:
    • Researches and resolves problems with patient accounts from site requests.
    • Works with providers to communicate coding issues and submit adjustment journals as needed.
  • CRWQ:
    • When working in the charge review work queue, follows workflows consistent with the policies of the Compliance Plan.
  • Surgery Scheduling:
    • Schedules surgeries for physicians at local surgery centers and hospitals.
    • Creates and maintains surgery schedules for physicians and notifies them of their schedules.
    • Updates EPIC with physician schedules and opens up office time slots when applicable.
    • Confirms all surgeries with patients and facilities.
    • Works closely with physicians to help keep the schedule flowing smoothly throughout the day.
    • Obtains authorization with insurance companies and verifies benefits for in-office procedures.
    • Performs patient registration functions by collecting and entering demographic and insurance-related information.
  • Referrals and/or Prior Authorizations:
    • Maintains current knowledge of insurance authorization and/or referral requirements.
    • Obtains authorizations from insurance carriers in a timely manner.
    • Acts as a resource for patients and staff with authorization and/or referral-related questions/problems requiring resolution.
    • Communicates authorization and/or referral information to patients and specialist offices in a timely manner.
    • Serves as a liaison between Primary Care and Specialty offices.
    • Coordinates medical record information for transmission to specialist’s office.
    • Responsible for maintaining access to online resources.
    • Ensures authorization and/or referral information is properly documented in Epic.
    • Informs physician of patient compliance with referral plan.
    • Maintains authorizations and/or referrals to ensure specialty visits are covered (Specialty Offices).
    • Coordinates with Primary Care Offices as needed (Specialty Offices).
    • Informs physicians and management of any issues causing a delay in the authorization process.
• Responsible for coordinating surgery details and appointments if applicable.
• Obtains insurance eligibility and benefit details.
• Performs other duties as assigned.

Requirements

• High school diploma or GED.
• Six or more months of experience working in the office of a healthcare-related facility.
• Experience using a PC in a Windows environment.
• Proficient in at least one of the following areas: CBO Site Requests, CRWQ, Surgery Scheduling, Hospital Tickets, or Referrals.

Preferred Qualifications

• Experience working with ICD-10 and CPT coding.

Certifications/Licenses

If working in the charge review work queue, must attend and complete all work queue training and successfully pass all tests based on the guidelines listed in the Compliance Plan.

Skills

• Excellent verbal and written documentation and communication skills.
• Knowledge of medical terminology.
• Familiarity with procedural and diagnostic coding.
• Familiarity with ICD and CPT coding methodology.
• Knowledge of medical insurance, collections, and appointments.
• Keyboarding ability.
• Excellent customer service skills.
• Excellent computer and keyboarding skills, including familiarity with Windows.
• Excellent interpersonal and problem-solving skills.
• Ability to work in a team environment.
• Ability to manage competing priorities.
• Ability to engage others, listen, and adapt response to meet others’ needs.
• Ability to perform job duties in a professional manner at all times.
• Ability to align own actions with those of other team members committed to common goals.
• Ability to understand, recall, and communicate factual information.
• Ability to understand, recall, and apply oral and/or written instructions or other information.
• Ability to organize thoughts and ideas into understandable terminology.
• Ability to apply common sense in performing job.

Schedule

Monday - Friday, 8 AM - 5 PM.

Works holiday shift(s) as required by Company policy.