Job Description

Job SummaryJOB SUMMARY
The Patient Access Center - Patient Access Scheduler position exists to assure that patients referred between employed and aligned physicians are scheduled to receive services in their assigned location and are financially cleared prior to their scheduled appointment, through accurate and timely scheduling, registration, and verification of eligibility and benefits. This position exists to assist management with ongoing observations and notifications of opportunities, while providing innovative suggestions for process improvement. This role will assist management with auditing/quality review to ensure accurate and appropriate scheduling and registration. Additionally, the position exists to provide excellent customer service when communicating with patients who visit our clinics. It also exists to provide notification to patients, physicians, and management of issues that may result in potential service delays or reimbursement denials.
Requirements:

DUTIES AND RESPONSIBILITIES
PEOPLE- 30%
1. This employee will use independent judgment and clinical knowledge to adjust clinic and physicians schedules and accommodate special requests from internal and external customers as indicated.
2. This employee will work with the physician templates and clinical protocols directly as indicated by management and physicians on an as needed basis
3. The employee will have interactions with all levels of staff and management, physicians, patients and families to obtain information and properly schedule and register services.
4. The employee will be responsible for the Patient Access Center directly and triage calls as appropriate to other areas as received on a daily basis while working under the guidelines and scripts as set forth by management
5. Provide patients with information needed to prepare for appointment per Center/Service protocol. Enroll patients on the Patient Portal and provide PIN numbers, complying with HIPAA regulations.
6. Keeps open channels of communication with all parties involved: physician, patient, service areas, regarding action taken and resolution.
7. Responsible for promoting a friendly and professional customer service environment.

SERVICE -30%
1. Utilizes courteous and professional telephone techniques and interpersonal skills to establish and maintain rapport with patients, physicians/office personnel and various hospital personnel, while maintaining patient confidentiality. Appropriately utilizes ACD/CISCO telephone system.
2. Use Department scripting and Appointment scheduling policy when scheduling appointments and ensures ICARE values are met while working within the scripting provided.
3. Assist with new referral from E-fax, Emails along with specific doctor's offices calling directly to schedule emergency patients same day or within 24 hours
4. Provides coverage for operator during transitions and as needed per management discretion.
5. Responsible for managing the flow of patient referrals:
1. Collecting and compiling data/information from patients such as insurance documentation and patient identification information to help facilitate an appointment with a SPG/PCG provider.
2. Screen and assess patient calls received and assure that the patients are scheduled for services as requested by referring physician.
3. Schedule patient appointments.
4. Verify patient benefits for eligibility.
5. Efficiently complete registration.
6. Pre-certify with insurance companies if necessary.
7. Answer incoming calls from patients regarding the status of their referrals progress.
8. Act as liaison between the patient and the physician.
9. Handle calls from physician's offices, always making sure to maintain a good relationship.
10. Obtain all necessary documents needed to support the referral process.
11. Close out referral process.
6. Help facilitate and coordinate and resolve referral issues with patients by exhibiting and exercising exceptional telephone, verbal, written, exemplary critical thinking and interpersonal communication skills.
7. Provided empathetic patient care by focusing on maintaining friendly, and incredibly dynamic environment.

FINANCE -20%
1. This position will work directly with the revenue cycle team and other departments to ensure the correct information and registration is complete and accurate prior to the patient visiting the clinic. This position will identify areas of concern and improvement to better the team and the overall practice in collecting revenue from front end operations being faulty.
2. Obtains and inputs accurate scheduling and registration data, including but not limited to: patient demographics, insurance, guarantor and clinical information on the information system in order to initiate financial clearance activities: benefit eligibility and verification, pre-certification notification and payment review.
3. Documents patient's accounts with information related to any potential issue(s) that could result in service delays or cancellations due to the lack of financial clearance.

QUALITY/SAFETY-15%
1. Maintain HIPPA Guidelines
2. Utilize resources to perform verification of patient insurances. Obtains required data in order to support departmental and hospital clinical/financial needs.
3. Maintain standard of productivity set by department policy and procedures
4. Uses established auditing procedures to process appointments and registrations.
5. Maintains internal controls for ensuring verification and eligibility is met and established correctly prior to patient visit.
6. Provide patients with information needed to prepare for appointment per Center/Service protocol. Enroll patients on the Patient Portal and provide PIN numbers, complying with HIPAA regulations.
7. Utilization requirements and addressing physician/patient requests or needs. Identifies and assigns correct medical record numbers.
8. Follows all safety rules while on the job. Reports accidents promptly and corrects minor safety hazards Report to management observed issues and opportunities in processes while including troubleshooting and problem solving.
9. Provide team with ongoing coaching and training needs to include new hire training, one on ones, auditing, shadowing, and communication with clinic office staff for updates.

GROWTH/INNOVATION -5%
1. Answer calls in a timely manner.
2. Works directly with physicians, office staff, and patients to ensure best practices within department.
3. Works with manager to improve areas requiring concern as indicated and strives for excellence in the workplace.

This position description is not intended to be all inclusive, and the employee will also perform other reasonably related business duties as assigned by the immediate supervisor and other management as required. The Houston Methodist Hospital reserves the right to revise or change job duties and responsibilities as the need arises.

Qualifications:

EDUCATION REQUIREMENTS
High School Diploma or G.E.D.; Associate's Degree preferred.

EXPERIENCE REQUIREMENTS
Three or more years of experience at the physician/practice level is preferred. Clinical knowledge and experience preferred with a strong understanding of medical terminology.

SPECIAL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
* Excellent communication and interpersonal skills via telephone and in person.
* Demonstrated proficiency in medical terminology to include diagnoses, operative procedures, and CPT codes.
* Medical terminology and applicability.
* Excellent spelling/grammar skills.
* Basic knowledge of medical terminology.
* Working knowledge of PC environment utilizing Windows and 25 wpm word processing. Basic Excel knowledge.
* Capable of working and navigating several applications and Web sites related to registration simultaneously.
* Managed care experience with the ability to differentiate between insurance plans such as PPO, POS, HMO, etc.

CERTIFICATES, LICENSES AND REGISTRATIONS REQUIRED
Satisfactory completion and clinical licensure such as MA, LVN program preferred.