Patient Visit Specialist-SF

Presbyterian Healthcare Services • Santa Fe, NM

11d • $16 - $24 • Onsite

About The Position

Performs visit closure activities to coordinate patient care while providing an exceptional patient experience for successful completion of next steps ordered by the clinician Advanced scheduling for specialty or radiologic procedures Recognizing payor requirements and obtaining prior authorization/certification/referrals for visits/procedures Processes daily referral workqueues for authorization, deferring only those that require payor consideration Primary Care and most Specialty Care offices must process STAT and ASAP referral workqueues for results received Return scheduling knowledge to include the ability to scrub schedules for accuracy and efficiency in home department Monitor in-baskets and reports for overdue results, waitlisted appointments, recalls, etc

Requirements

• High school or equivalent
• Short-term training in Medical Terminology
• Familiarity with CPT and ICD-10 coding
• Minimum 18 months experience in a clinical setting with significant MD interaction
• Proficiency in prior authorization/certification/referral process
• Must pass EPIC competency for Registration at completion of Epic Clerical Training class
• Pass annual competency exam for all areas of responsibility.
• Attend Quarterly MSO meetings.
• Attend Staff meetings
• Attend Employee Forums
• Requires strong organizational and multi-tasking skill sets
• Significant customer service skill set paramount
• Must be able to function under pressure while maintaining professionalism
• Working knowledge of CPT and ICD-10 coding
• Pass annual competency exam for all areas of responsibility.
• Attend Quarterly MSO meetings.
• Attend Staff meetings
• Attend Employee Forums

Responsibilities

• Customer Service and Caring Practices: Achieve exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools. Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times Ability to manage conflict and appropriately request the help of a supervisor when needed Fosters effective patient relations with patients, the public and providers by listening, responding and escalating whenappropriate Round with patients waiting to insure their comfort and to inform of delays when applicable
• Encounter Components: Review and follows order entered into the EHR by the clinician Schedule return visits lab, radiology, STAT & ASAP appointments and advanced imaging Obtain Prior Authorization/Referral per payor protocols Validates patient MyChart Access Prints AVS as applicable with double check for HIPAA privacy Collects any backend patient balance such as high deductible Communicates effectively to ordering clinician when any restriction, such as access, restricts or prohibits scheduling as ordered
• Financial Accountabilities: Refers as appropriate to on site Financial Advocate, or for uninsured to the Financial Advocacy Center Validate prior authorization/certification/referral are secured PRIOR to a scheduled procedure or test, alerting stake holders(patient, patient representative, OR, etc) if a breakdown occurs
• Message Management: Formulates complete and accurate telephone encounter messages and routes to the appropriate Epic in-basket pool to supportoperational aspects of patient care.
• Medical Record Components: Instructs patients on the Release of Information process and insure a fully completed ROI Form is submitted to Health InformationManagement for incoming or outgoing records
• Patient Relations Comprehend quality service connection to patient satisfaction and reimbursement Participate in metric goals for telephones performance metrics, TSF and abandonment rate when applicable Perform confirmation calls when applicable to include directions and instructions as required by the visit type
• Patient Safety Respond quickly to patients showing distress. Follow guidelines set forth by the Clinic Manger to alert the clinical team. Assist inany manner the clinic team directs. Ensure check out area, waiting area and walkways are clear of any unnecessary items and are clean and neat. Report any concern that may create a safety issue. Annual competency completion of Clerical Staff during a Code Blue
• Quality Improvement: Appointment reminder calls Rescheduling Evaluate provider schedules and take appropriate action to ensure accuracy and efficiency per guidelines Works with assigned physicians to maximize schedule effectiveness
• Demonstrates CARES behaviors of Collaborate, be Accountable, Respect, Engage and Serve to all whom you encounter.

Benefits

• All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
• Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees