Job ID 2100084N
Available Openings 1
Position Specific Information
Position is M-F must have availability 7:30 AM- 5:30 PM
at least one year experience in a front office position knowledge of insurance-
5815 South Rainbow Boulevard 110, Las Vegas, 89118
PURPOSE AND SCOPE:
The PCA Patient Care Coordinator's role is to schedule patient's visits, tests and procedures; answer all patient questions; and help patients and their families make informed decisions throughout their treatment. The incumbent is also responsible for answering all incoming calls in a timely manner and directing the caller to the appropriate destination while providing a smooth, clear and professional communication practice.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Under general supervision, follows established company policies and procedures and applies acquired job skills to:
Patient Care Coordination
- Identifies patients' important needs, answers to their questions, and assists with informed patient decisions that may arise prior and/or post office visits/testing appointment time.
- Provides patient practical resources and offers emotional support and understanding throughout patient care coordination process.
- Coordinates scheduling and clinical needs for patients who are enrolled in PCA's Special Programs (CHF, AUH-Avoid Unnecessary Hospitalization, Urgent Referral, PACE program, and Mobil clinic, etc.).
Schedule patient appointments including office visits and non- invasive testing
- Enters new patient demographics and updates established patient information, as necessary, in EHR to maintain accurate patient medical records.
- Obtains both new and established patient insurance information including eligibility and authorization necessary for patient scheduling and billing purposes.
- Schedules patient appointments including office visits (consult and follow up) and non- invasive testing pursuant to PCA's outpatient scheduling policies and procedures.
- Provides detail patient educations/instructions as directed and in conjunction with PCA physicians, nurses and other clinical staff.
- Requests pertinent medical records in relates to scheduled appointments in a timely manner.
- Reschedules patient appointments according to EHR advanced schedule templates due to physicians, mid-levels and technicians' planned and unplanned time off. Only reschedules patient appointments that are pre-approved by the PCC Manager.
- Monitors the assigned physicians' schedules closely and documents all patient “no show” and “cancellation” in EHR and notifies patients, referring/treating providers pursuant to PCC policies and procedures.
- Follows directions from the PCC Manager and Manager of Administration and Outreach Services on reviewing and correcting scheduling issues when they arise.
- Interacts with involved PCA clinical team members to expedite and facilitate scheduling and completion of testing, procedures and office visits; maintains ongoing communication regarding variance from the care plan in regards to scheduling.
- Consistently meets or exceeds PCC department productive benchmark (scheduling volumes, call volumes, accuracy of the appointment scheduled, documentation, etc.).
- Responsible of triaging and accurately transferring the caller to the appropriate staff member.
- Promptly answers and responds all calls in a professional manner. Takes accurate messages, ensures that messages are delivered to appropriate person/department. Conveys urgent and relevant patient care information to other members of the health care team in a timely manner.
- Interacts and assists clinical and administrative personnel at hospitals, health plans and IPAs.
- Scans authorizations, medical records & other patient records as needed.
Patient & Referring Physician Satisfactions
- Maintains and improves excellent customer service relationships with incoming PCA patients and their referring service providers by improving organizations, flow and tracking of incoming referrals for PCA services.
- Reinforces “PCA's Patient Partnership Plan” with all new and established patients and reports patients' scheduling non- compliance issues to the referring and treating physicians in a timely manner.
- Consistently follow PCA administrative and clinical policies and procedures.
- Maintains patient, company and employee confidentiality. Comply with HIPAA policies and procedures and PCA's Code of Conduct.
- Attends and participates in department/unit based staff meetings.
- Consistently completes work within designated timeframes.
- Maintains a clean environment, free of food, drink and hazards. Promotes safe environment both for patients and staff by adhering to PCA Policies and Procedures.
- Completes PCA employee annual education requirements (HIPAA, safety, sexual harassment in-house training, etc.) and/or maintains current license/certificate as applicable.
- Reviews and complies with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations.
- Assists with various projects as assigned by direct supervisor.
- Other duties as assigned.
Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions.
PHYSICAL DEMANDS AND WORKING CONDITIONS:
The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
High School Diploma or GED required.
EXPERIENCE AND REQUIRED SKILLS:
- 1 – 2 years' related experience.
- 1-3 years of medical appointment scheduling and insurance verification experience required.
- 1-3 years of patient care coordination experience in cardiology practice preferred.
- Valid driver's license.
- Demonstrate exceptional phone skills and ability to handle large volume of phone calls.
- Knowledge of medical insurance including eligibility, authorization, insurance benefits and billing.
- Knowledge of medical terminology.
- Knowledge of electronic medical records.
- Bilingual preferred.
EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity
Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.
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