JOB DESCRIPTION

The position description is a guide to the critical duties and essential functions of the job, not an all-inclusive list of responsibilities, qualifications, physical demands, and work environment conditions. Position descriptions are reviewed and revised to meet the changing needs of the organization.
TITLE: Specialty Services Coordinator
JOB OVERVIEW: The Specialty Services Coordinator position is responsible for scheduling and coordinating services for patients in multiple hospital-based specialty services and providers, as well as, clinic services, pre-registration, insurance verification, estimate creation, collection of payments over the phone, using inbound and outbound call handling, as well as a backup for in-person check in and MyChart requests.
DEPARTMENT: Patient Access, Clinic Network
WORK HOURS: As assigned
REPORTS TO: Manager, Patient Access or Clinic Network

QUALIFICATIONS:

• Ability to function effectively and interact positively with patients, peers and providers always.
• Ability to access, analyze, apply and adhere to departmental protocols, policies and guidelines.
• Ability to provide verbal and written instructions.
• Demonstrates understanding and adherence to compliance standards.
• Demonstrates excellent customer service skills throughout every interaction with patients, customers, and staff:
• Ability to communicate effectively in verbal and written form.
• Ability to actively listen to callers, analyze their needs and determine the appropriate action based on the customer’s needs.
• Ability to maintain a calm and professional demeanor during every interaction.
• Ability to interact tactfully and show empathy.
• Ability to communicate and work effectively with the physical and emotional development of all age groups.
• Ability to analyze and solve complex problems that may require research and creative solutions with patient on the telephone line.
• Ability to document per procedural template requirements, gather pertinent information and enter data into computer while talking with callers.
• Ability to utilize third party payer/insurance portals to identify insurance coverage and eligibility; detailed knowledge of insurance providers, their portals and their expectations for authorization approval for referral services/appointments.
• Ability to function effectively in an environment where it is necessary to perform several tasks simultaneously, and where interruptions are frequent
• Ability to organize and prioritize work.
• Ability to multitask while successfully utilizing varying computer tools and software packages, including:
• Utilize multiple monitors in facilitation of workflow management.
• Scanning and electronic faxing capabilities
• Electronic Medical Records
• Telephone software systems
• Microsoft Office Programs
• Ability to successfully navigate and utilize the Microsoft office suite programs.
• Ability to work in a fast-paced environment while handling a high volume of inbound calls.
• Ability to meet or exceed department performance standards for Registration Quality, Productivity and Collections.
• Ability to speak, spell and utilize appropriate grammar and sentence structure.

QUALIFICATIONS:

• Ability to function effectively and interact positively with patients, peers and providers always.
• Ability to access, analyze, apply and adhere to departmental protocols, policies and guidelines.
• Ability to provide verbal and written instructions.
• Demonstrates understanding and adherence to compliance standards.
• Demonstrates excellent customer service skills throughout every interaction with patients, customers, and staff:
• Ability to communicate effectively in verbal and written form.
• Ability to actively listen to callers, analyze their needs and determine the appropriate action based on the customer’s needs.
• Ability to maintain a calm and professional demeanor during every interaction.
• Ability to interact tactfully and show empathy.
• Ability to communicate and work effectively with the physical and emotional development of all age groups.
• Ability to analyze and solve complex problems that may require research and creative solutions with patient on the telephone line.
• Ability to document per procedural template requirements, gather pertinent information and enter data into computer while talking with callers.
• Ability to utilize third party payer/insurance portals to identify insurance coverage and eligibility; detailed knowledge of insurance providers, their portals and their expectations for authorization approval for referral services/appointments.
• Ability to function effectively in an environment where it is necessary to perform several tasks simultaneously, and where interruptions are frequent
• Ability to organize and prioritize work.
• Ability to multitask while successfully utilizing varying computer tools and software packages, including:
• Utilize multiple monitors in facilitation of workflow management.
• Scanning and electronic faxing capabilities
• Electronic Medical Records
• Telephone software systems
• Microsoft Office Programs
• Ability to successfully navigate and utilize the Microsoft office suite programs.
• Ability to work in a fast-paced environment while handling a high volume of inbound calls.
• Ability to meet or exceed department performance standards for Registration Quality, Productivity and Collections.
• Ability to speak, spell and utilize appropriate grammar and sentence structure.

ESSENTIAL RESPONSIBILITIES AND COMPETENCIES:

• The responsibilities outlined in the Patient Access Associate job description.
• Responsible for scheduling and coordination of multiple providers schedules, including but not limited to Radiologist, nursing, anesthesia, etc., registration, insurance verification, estimate creation, collection of point of service payments for services supported by their department, this includes:
• Complex scheduling coordination services for multiple hospital and clinic services supported by department.
• Confirms referrals received for services are complete and accurate.
• Uses EPIC to gather necessary scheduling information such as patient acuity using snap board to view scheduling regimens, referral and patient WQ’s or ancillary orders to ensure timely throughput.
• Proficient in complex scheduling; requiring coordination of multiple resources external to EPIC, i.e. ensuring pre-requisites are completed (such as labs, films and medical history), appropriate clinical resources are available.
• Coordinates requests for additional information from referring offices as required for complete and accurate scheduling and reimbursement.
• Utilizes protocols to identify when escalation is needed based on the symptoms that patients report when calling.
• Outbound dialing for referral work queues:
• Utilizes referral work queue to identify patients that have an active/authorized referral in the system and reaches out to complete scheduling process.
• Schedules per department protocols
• Updates the referral in alignment with the defined workflow.
• Confirms services provided at Valley will be covered by patient’s insurance and if we are out of network, informs patient benefit limitations.
• Generates patient estimates and follows Point of Service Collection (POS) Guidelines to determine patient liability on or before time of service. Accepts payment on accounts with Patient Financial Responsibility (PFR) as well as any outstanding balances, documents information in HIS and provides a receipt for the amount paid.
• Prior to services, confirms the account meets financial clearance criteria, if unable to financially clear the account, refers to FA or management for assistance.
• Completes the MyChart Scheduling process for appointment requests and direct scheduled appointments.
• Utilizes patient and referral WQ’s to ensure accounts are actively worked and documentation is complete.
• Schedules per department protocols
• Responsible for organizing and prioritizing work as outlined in department standard workflows.
• Receives, distributes, and responds to email, volte, Inbasket messages, and in-persons requests.
• Meet defined targets for productivity, POS collections and financial clearance.
• Receives, distributes, and responds to mail for work area, including checking referral WQ’s, Aspect, Epic Inbasket and faxes according to department standards.
• Monitor office supplies and equipment, keeping person responsible for ordering updated.
• Other duties as assigned.
  Created: 1/25
  Grade: OPEIUE