GENERAL SUMMARY/ OVERVIEW STATEMENT:
The Patient Services Coordinator III functions within the ambulatory practice as the pod/unit team coordinating administrative functions within the group. Assists Department administration with the effective management of the practice's daily operations and revenue enhancement.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Perform all duties and responsibilities of a PSC 1 and II.
Coordinates the scheduling of multiple appointments using multiple systems or resources.
Investigates and resolves issues relating to and arising from the referral and/or billing process, which interrupts the delivery of care to a patient or the reimbursement for services rendered. Addresses patient questions, complaints and concerns.
Functions as the pod/unit resource for referral and insurance issues. Remains current on the changing issues impacting the health care insurers. Attends meetings as necessary.
Function as the pod/unit "Super User" for EPIC CADENCE scheduling system.
Possesses a thorough knowledge of all HMO, managed care, other third-party insurers, and available patient financial services/resources.
Identifies and communicates to the Practice's leadership issues of process creating inefficiencies within the operation. Assists in their resolution, working within the pod and with management for the department as a whole.
Coordinates the workflow and schedules within the pod/unit to insure an efficient daily operation. Troubleshoots workflow issues, as needed, working with pod management to coordinate staffing and replacement coverage.
Conducts or arranges for pod/unit specific training for new secretarial hires, while coordinating with the practice-training mentor.
Works to ensure HIPAA Confidentiality and Privacy Policies is fully implemented.
Assists with special projects as required. Projects may include such topics as obligations to insurers, hospital issues of compliance and/or Operations Improvement Initiatives.
Manages Epic Referrals inside and Outside referrals that come into the Practice.
Triages and manages patient telephone calls, utilizing courteous customer service skills.
Provides cross coverage for other Practice staff members for absences, vacations, etc. and during variations in workflow, as needed.
Performs Surgical Booking, which includes coordinating PATA and other necessary appointments.
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
- Schedule's patient surgeries, pre-testing; completes, delivers, and files all associated paperwork in an accurate and timely manner.
- Is knowledgeable in the use of the MGH OR Schedule and Information System -OR Scheduling System, Epic and the PATA Online Scheduling pre-admission testing program.
- Schedules PATA, Pre-operative and Post-Operative appointments in a timely and courteous manner; prepares appropriate paperwork and confirms that any necessary follow-up is scheduled at the appropriate time in the future.
- Ensures completed consents, orders and H&P is sent to PATA or SDSU to be present for the patients' surgery. Forwards all original copies to the Medical Records Department.
- Consistently provides patients/family with copies of surgery instructions for appropriate type of admission.
- Ensures that required pre-authorization forms are filled out by either the physician or the nurse when necessary.
- Refers patients to Patient Financial Services for financial counseling as appropriate.
- Distributes information to patients pertaining to surgery and pre-admission testing, directions to appointments, maps, etc. (prior to surgery).
- Answers patient/family questions regarding appointments, surgical procedures, and pre-operative instructions as appropriate. Refer all medical questions to the appropriate person.
- Arranges for interpreter services as needed prior to patient's pre-operative, post-operative and PATA appointments, as well as day of surgery.
- Ensures that all demographic data in the patient's medical record is current and complete; directs to MGH Registration and Referral Center (RRC) if applicable.
- Re-schedules any cancelled surgeries in a timely manner.
- Responds to requests from billing service or third-party carriers for information, corrections, etc., related to the physician's surgical procedures.
- Ensures equipment requested by the physician is entered in the OR Scheduler. Schedule inter-op U/S guidance when requested by the physician.
- Request the presence of a company representative for new procedure when indicated
- Assist other Gyn offices to find OR time outside of their block time when necessary.
- Sends a confirmation e-mail to the physician once the patient is confirmed for surgery. Enters the information into Epic.
- If a case will go beyond 5:00 pm contact the appropriate OR Administrator to request approval.
Demonstrated experience to interface with various levels of the practice, especially with the knowledge and issues related to manage care.
Thorough knowledge of EPIC CADENCE system modules and its features, electronic medical record modules and with all system features, as applicable.
Demonstrated ability to work independently, with limited supervision, resolve issues, be organized, attentive to detail and achieve outcomes within the team.
Demonstrates effective interpersonal and communication skills.
Effectively interacts with all levels of management.
Demonstrates knowledge of HIPAA Confidentiality and Privacy policies.
Demonstrates an understanding of Disaster protocols to include fire, safety, code calls, per the mandatory training, as outlined by MGH and JCAHO guidelines.Qualifications
Associate degree in Secretarial Science/Business, or a Secretarial Training Certificate Program preferred
Minimum of 3 years work experience in medical group practice, billing and/or managed care setting required.EEO Statement
Massachusetts General Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. Applications from protected veterans and individuals with disabilities are strongly encouraged.