Job Summary:Under general supervision, the Ambulatory Care Patient Specialist provides administrative support to health care providers in a multidisciplinary ambulatory setting, functioning as the primary interface between the patient and the providers. The emphasis is placed on the ability to organize priorities, complete tasks, manage confidential patient information, schedule patient appointments and diagnostic testing, referrals and other managed care related issues. They must also be able to manage a patient’s entire flow through the Revenue Cycle Process to ensure referrals/pre-authorization, check-in, check-out, and charge entry.Essential Job Duties and Responsibilities
Enters and tracks patient appointment in scheduling system.
Pre-registers patients, obtains, verifies and records personal, demographic and financial information via telephone or other electronic interview. Collects this information accurately and comprehensively in a sensitive and timely manner.
Works with Primary Care Physician offices to obtain referrals and authorizations. Verifies patient insurance coverage with Third Party Payers, determines eligibility and benefits, and obtains referrals by utilizing appropriate technology.
Delegate clinical messages to designated provider.
Provide daily reconciliation reports for each physician, detailing:
Co-Payment Reconciliation
Encounter Form (Charges) Reconciliation
Scrub encounter forms to ensure all necessary fields are completed. Refers to appropriate resource to complete missing information.
Performs charge entry functions.
Understands financial services and self-pay resources, and provides patients with information and referrals to financial counseling as needed.
Triages and manages complex telephone calls utilizing courteous customer service skills.
Maintains confidentiality and privacy consistent with HIPAA guidelines.
Schedules patient appointments via phone calls and follow-up appointments in office.
Provides cross-coverage for other practice staff members for absences and vacations as well as during variations in workflow.
Assists in training and orienting new staff, to front desk procedures and best practices.
Performs all other related tasks facilitating patient flow and quality patient care.
Works on special projects as assigned.
Performs office duties efficiently, such as:
Collecting and distributing mail and faxes that arrive at the office
Separating payments received via mail for the practice.
Scans all relevant documents.
Performs other duties as assigned.
Qualifications
Essential Qualifications, Knowledge, Skills, and Abilities Required for the PositionKnowledge of:qWorking knowledge of Microsoft Office applications.qKnowledge of medical terminology preferred.qDemonstrated in-depth understanding of managed care and all other pertinent insurance/medical coverage.qDemonstrated knowledge of HIPAA Confidentiality and Privacy Policies.qDemonstrated understanding of disaster protocols to include fire, safety, and code calls, pursuant to the mandatory training requirements outlined by NCH and JCAHO guidelines. Skills:qCommand of the English language including some medical terminologyqExceptional organization skills, ability to multi-task, accurate attention to detail.qExcellent and effective interpersonal and communication skillsAbility to:qAbility to tactfully communicate with both internal and external customers.qAbility to handle stress and work in emergency situations.qAbility to use of fingers and hands to operate all department-related equipment as described on the Department checklist and to perform all job duties.Additionally, must use beeper, telephone, calculator, fax, scanner and other related office equipment.qAbility to frequently bend, using back and knees.qAbility to stand and walk 30%, sit 70% of the time.Ability to frequently climb, bend, reach, stoop, squat, help lift objects from five to twenty pounds and move patients via wheelchair or stretcher.qAbility to present themselves in a professional manner.qAbility to work both independently or with a team approach.qDemonstrated ability to work effectively and courteously with various groups of patients, staff, and providers.qDemonstrated ability to problem solve, function as a resource to other members of the team, and resolve complex issues on behalf of the providers and the patients.Credentials and Experience Required qAssociate’s Degree in Secretarial Science/Business, or a secretarial training certificate program desirable, preferred.qMedical experience in a Doctors office is strongly preferred.qMinimum of 2 years secretarial experience or equivalent in a medical or health care related setting.qDemonstrates excellent Customer Service skills.qComputer skills necessary to use appropriate modules of IDX, electronic medical record modules, and transition to PATCOM, as required.qValid driver’s license preferred to run errands locally or if delivery of equipment is required.qSpecial Requirements qRegular workweek requiring minimal additional hours. Some days, evenings, weekends and holidays may be required for this position.qMust be available to work in the case of a declared hospital emergency.
