Scheduling & Preauthorization Coordinator Ii

Company Description

Renowned as the academic flagship of the University of Maryland Medical System, our Magnet®-designated facility is a nationally recognized, academic medical center with opportunities across the continuum of care. Come join UMMC and discover the atmosphere where talents and ideas come together to enhance patient care and advance the science of nursing. Located in downtown Baltimore near the Inner Harbor and Camden Yards, you won’t find a more vibrant place to work!

General Summary

Under supervision of the Practice Manager, acts as a lead to the front desk staff and their work functions. Assist the practice manager in developing and administering departmental policies and procedures to ensure an efficient collection and authorization acquisition process. Maintains consistent and accurate communication with the Medical System staff, referring physicians and patients.

Principal Responsibilities And Tasks

The following statements are intended to describe the general nature and level of work being performed by people to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

• Assists Practice Manager in conducting orientation and training of new employees.. Actively and continuously improves work processes. Uses continuous improvement tools and methods to improve individual, team and cross departmental performance. Bases improvement on customer requirements, data root cause analysis and outcomes.
• Responsible for batching STAR and IDX encounter forms on a daily basis, checking forms for completeness. Check completed forms against daily schedule to maintain that no forms are missing.
• Oversees that the front desk staff maintains a less than 10% error rate on their registration error report by reviewing schedules in advance and notifying patients, as necessary, for required referral and authorizations.
• Assists staff to maintain that patients insurance and referrals are checked one day prior to the appointment.
• Oversees the scheduling of patient appointments, procedures and diagnosis tests. Provides printed schedules in advance to physicians, nurses, radiology etc. on a daily basis.
• Oversees/verifies patient demographic and financial information, confirms insurance coverage referral and or authorization information, accurately registers patients in the STAR and IDX systems.
• Complies with IDX scheduling standards. Monitors overbooking and/or conflicting scheduling situations and informs the clinic manager..
• Understands UMMS and specific clinical services coverage policies and communicates to staff and patients.
• Reviews schedule for co-pay obligations and outstanding balances and flags patients accounts. Alerts staff and patients to prior balances and co-payments.
• Provides guidance and instruction to fellow employees where skills are in need of improvement, as needed. Provides information to Practice Manager regarding work progress, actions and issues in a timely and effective manner.
• Maintains inventory and orders appropriate supplies for the clinic.
• Collects and tracks encounter forms. Responsible for collecting 100% of encounters forms at the end of the business day. Checks encounter forms for accurate patient information, ICD 9 codes, time spent with patient for facility charges and physician signature.
• Collects and checks encounter forms for completeness and accuracy. With knowledge of insurance rules and regulations, collects appropriate co-pays and coinsurance payments. Compiles encounter form batches, both hospital and practice, links referrals and enter STAR charges in a timely manner.
• Coordinates and supervises the daily functions of the front desk staff. Oversees/ performs patient registration activities, assuring accurate, complete and timely processing of appropriate documents.
• Maintains that staff enter all STAR charges by the end of the business day. Responsible for accuracy and checks Daily Revenue Report the next day for any missed or incorrect charges.
• Assures that staff collect appropriate co-pay and facility fees, completes receipt and payment logs. Secures payments in cash box/safe as appropriate. Provides the patient with proper documentation and receipts.
• Answers telephone and patient inquires. Responds to inquires, takes legible, accurate and complete messages. Locates provider or nurse when appropriate.

Qualifications

Education and Experience

• High School Diploma or equivalent (GED) is required.
• Two years office work in a medical office or healthcare environment is required. Registration, front desk, referral services and billing experience preferred. In addition, two years of supervisory or lead worker experience.

Knowledge, Skills And Abilities

• Ability to listen to patient complaints and resolve them using positive, proficient guest relation skills. Ability to use resourcefulness and problem-solving skills in appropriately resolving various patient scheduling issues.
• Knowledge of medical terminology in order to understand diagnoses to schedule appointments.
• Ability to work independently; ability to respond effectively under stress.
• Ability to prioritize and manage numerous tasks in different stages of completion.
• Successful completion of the UMMS computer systems certification test within one attempt and maintain a minimum of 90% accuracy.
• Maintain a < 10% registration error rate as a departmental specific goal for registration accuracy.
• Proficient in PC applications and accurate data entry. Use of other medical registration system and/or STAR/IDX preferred..
• Highly effective communication skills are required to relate to multiple levels of clinical and administrative personnel and to advise patients and visitors about hospital policies and procedures. Effective written communication skills are also required in completing admission and other documents properly.
• Understanding of ICD9 codes is preferred.
• Demonstrated ability to listen to patient information and translate information into written documentation.

Patient Safety
Ensures patient safety in the performance of job functions and through participation in hospital, department or unit patient safety initiatives.

• Reports adverse events and near misses to appropriate management authority.
• Identifies possible risks in processes, procedures, devices and communicates the same to those in charge.
• Takes action to correct observed risks to patient safety.

Additional Information
All your information will be kept confidential according to EEO guidelines.