Under general supervision, responsible for performing the Patient Access Process components including scheduling, registration, and insurance verification. Interacts with patient and physician office staff to schedule basic cardiology future services for patients including the coordination of multiple cardiology services in proper sequence, as well as informing patient/doctor's offices of test preparations, insurance requirements, authorizations and financial responsibility for each service. Analyzes tests/procedures ordered with the signs & symptoms for the studies to make appropriate decisions regarding the services needed and the appointments required. Collaborates with multiple locations to best utilize resources, while accommodating physician preferences and patient needs. Speaks directly with departments to resolve numerous scheduling matters including STAT appointments, approvals, block times and appropriate selection of studies to schedule. Manages physician orders and other clinical documentation to ensure it is available and accurate for clinical staff at the time of patient service Responsible for the complete and accurate collection of patient demographic and financial information to create the preregistration episode. Verifies the patients’ insurance and source of payment and determines the coordination of benefits for scheduled services, as well as prevailing regulatory and 3rd party requirements.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
1. Interviews patients and physician office staff to obtain information and appropriately schedule patients for future and same day basic cardiology services
2. Interprets information collected to determine and create comprehensive patient and visit specific medical and billing records.
3. Determines need for authorization for treatment/procedures and coordination of benefits as required.
4. Utilizes multiple system applications simultaneously to complete the scheduling, order management pre-registration and insurance verification processes.
5. Provides information to patients concerning hospital policies and regulatory requirements utilizing exceptional interpersonal skills.
6. Obtains dates of previous services to determine eligibility for future services
7. Uses prior study physician recommendations to determine appropriate next test to schedule.
8. Translates clinical information on physician orders to clinical order terminology to appropriately schedule patients for future services.
9. Responsible for scheduling STAT appointments, block appointments and obtaining department approvals for complex procedures.
10. Processes internet requests for scheduling services. Ensures appropriate communication to patient requesting services.
11. Verifies insurance coverage using Real Time Eligibility for selected services to facilitate cash collection.
12. Performs medical necessity screening for applicable services for Medicare patients. Follow-up with patients and ordering physicians appropriately to communicate responsibility related to services found to be not medically necessary.
13. Responds to problems and questions from Medical Records, Clinical Departments or PFS Teams.
14. Reviews, analyzes and corrects report entries to ensure accurate scheduling and registration, and makes sure insurance and billing requirements are met prior to services being rendered.
15. Demonstrates understanding of prevailing regulatory and 3rd party requirements (MSP, authorizations, PCA, consent forms, ABN, etc.).
16. Assists patients or physician office staff by referring them to the appropriate sources of information.
17. Identifies opportunities to improve the quality of scheduling, registration and/or verification processes.
18. Responds to patient questions concerning their scheduled services, registration, insurance eligibility and payment requirements as related to services they are scheduled to have.
19. Demonstrates accountability to follow-up with patients concerning requests for information of action regarding their appointment and/or account.
20. Knows where to obtain information to assist PFS team members, patients, and internal or external customers.
21. Demonstrates team-player abilities and seamless service to patients.
22. Maintains good rapport and cooperative relationships. Approaches conflict in a constructive manner. Helps to identify problems, offer solutions, and participate in their resolution.
REQUIRED EDUCATION, EXPERIENCE AND CERTIFICATION/LICENSURE
Education:
Requires high school diploma or equivalent.
1-2 years post high school education and/or training or the equivalent.
Experience:
1 to 2 years of related experience.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.