Provides scheduling and pre-registration service for patients needing services, procedures, tests and appointments. Verifies demographic information, insurance benefits and eligibility in order to ensure appropriate reimbursement for services. Refers patients to Biller to make arrangements and informs patients of financial assistance procedures as appropriate. Provides initial determination of those patients who require medical triage services and transfers calls appropriately. Provides outstanding customer service and satisfaction ensuring all patients feel welcome at Swedish and in the NorthShore Medical Group. Enables easy, convenient access to the services they need in a friendly, efficient and timely manner. Functions within the NorthShore Medical Group as part of a team to provide superior service and satisfaction to all internal and external customers.

ESSENTIAL DUTIES AND RESPONSIBILITIES

The responsibilities listed below are representative of the position and are not all-inclusive.

• Demonstrates a commitment to the mission of Swedish Hospital and the NorthShore Medical Group by demonstrating a customer service orientation and adheres to all responsibilities and standards of the hospital and Medical Group.

• Demonstrates professional and customer service focused behavior at all times, including manner of communication, responsibility and appearance.
• Answers high volume of incoming calls promptly, courteously, and in a caring friendly manner, ensuring outstanding customer service at all times.
• Accurately, appropriately and efficiently schedules appointments for multiple offices within the NSMG groups and adheres to specific department guidelines and protocols, ensuring service excellence at all times.
• Responsible for entering appropriate diagnoses and ICD-9 codes in compliance with Local Medical Review Policies.
• Gathers complete and accurate patient type, demographic and billing information. Pre-registers patients in a timely and efficient manner.
• Advises patient of any insurance authorization and referral requirements and ensures timely transfer of registration information to ensure financial clearance and appropriate reimbursement.
• Advises patients of the collections policy and explains payments, deposits and co-pays. Directs patient to the SMG Biller when necessary.
• Assists and supports new employees to make them aware of department policies and procedures, while emphasizing excellent quality and customer service excellence.
• Attends meetings regarding community, hospital events and classes.
• Responsible for generating reports/letters in an accurate, efficient and timely manner.
• Maintains accurate physician data for new doctors on staff, insurance information and other updates in the computer system. Maintains paper files and binders up to date as a back-up for computer down time, so that referrals can be done manually.
• Performs other duties as requested by the supervisor

ALLOWABLE ACCESS TO PROTECTED HEALTH INFORMATION

• Name, Demographic, Financial and Limited Clinical
• Computer system access is assigned based on managers access level request and on the minimum necessary as described in this job description. Approval for level of access is given by the system administrator or manager of the department that has ownership of system/module. See Computer System Access controls policy.

PATIENT CARE/AGE SPECIFIC RESPONSIBILITIES AND QUALIFICATIONS

N/A

QUALIFICATION/BASIC JOB REQUIREMENTS

Education & Experience

• High School graduate; prefer two or more years of health-related college course work.
• Minimum six months experience in hospital admissions, hospital department scheduling, or in physician office scheduling.

Knowledge & Skills

• Excellent interpersonal and customer service skills.
• Excellent phone voice – proper grammar, diction
• Basic knowledge of medical terminology, anatomy & physiology and coding.
• Knowledge of clinical office or department general policies and practices.
• Keyboarding at 45wpm.
• EPIC EMR experience a plus.
• Working knowledge of MS Office applications (Word, Excel, Power Point), intranet/internet, and web-based portal functionality.
• Knowledge of Medicare, Public Aid, and managed care payment and reimbursement requirements.
• Ability to prioritize and organize tasks, and to maintain flexibility in response to constantly changing demands
• Ability to concentrate and remain composed in a busy, distracting office environment in high-pressure situations.
• Ability to interact positively and effectively with multiple departments.
• Ability to use good judgment and utilize independent decision-making skills to effectively problem solve, resolve issues and facilitate department efficiency and productivity.
• Ability to prioritize and organize tasks and to maintain flexibility in response to constantly changing demands.

LICENSE/CERTIFICATION

N/A

INTERNAL AND EXTERNAL CONTACT

• Patients and patient family members
• Physicians and Physicians Office Staff
• NorthShore Medical Group employees
• Ancillary departments
• Medical Records

Primary Location

• Division of Ophthalmology, Professional Plaza