Physician Support Representative

University of Rochester•City of Rochester, NY

11d•$20 - $26•Onsite

About The Position

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Performs complex secretarial and administrative duties, in a fast-paced environment with minimal direction and considerable latitude for independent judgment, in support of the clinical, educational, and academic programs for the Faculty of Thoracic and Foregut Surgery. Responsibilities include time and calendar management, telephone triaging and management, prior authorizations and information/data support.

Requirements

High School Diploma required
Two years of relevant experience required or an equivalent combination of education and experience
Demonstrated customer relations skills
Excellent interpersonal skills and organizational skills
Medical Terminology, experiences with surgical/appointment scheduling software, and electronic medical records
Strong attention to detail and communication skills, including written communication
Working knowledge of word processing and spreadsheet applications
Experience in medical office setting
Experience with eRecord and Cadence

Nice To Haves

Associate's degree in Medical, Secretarial, billing, or related field preferred

Responsibilities

Receives incoming patient telephone calls for surgeon(s) and nurse practitioner(s), managing and/or resolving various scheduling/coordination issues and answering questions as needed.
Coordinate scheduling of patients at multiple practice sites; coordinates referrals for consults.
Triages telephone calls from patients and referring physicians to surgeons, residents and nurse practitioners.
Processes incoming referrals not generated within the UR system.
Perform a needs assessment using information from the electronic medical record to ensure the appropriate appointment/procedure is scheduled with the appropriate provider; ensure that accurate patient demographic and current insurance information is captured; adhere to RIM protocols for record verification
Manages the intake of new referrals through various sources, including the eRecord work queue, faxed referrals, and phone calls from outside providers.
Enters faxed referrals into the record system.
Ensures ancillary testing and other specialty referrals have been executed and results received and acted upon as needed.
Investigates failure to receive such information, troubleshoot, resolve, and/or make recommendations to ensure delivery/receipt.
Acquire insurance authorization for the visit and, if applicable, any testing; insurance authorization information will be entered in the Epic referral record for the patient, and referral records to any visits in which they are missing.
Provides patients with appointment and provider information, directions to the office location, and any educational materials if appropriate.
Documents all communications pertaining to the referral and/or insurance authorization in the notes section of the Epic referral record.
May perform complex appointment scheduling, linking referrals and ancillary services for the assigned specialty service.
Ability to make decisions that are guided by protocols and practices requiring some interpretation; maintains an expert-level understanding of the department/division.
Prior authorization functionality will be required for testing and services ordered by referred-to specialists, including but not limited to:
Prepares and provides multiple, complex details and facts to the insurance carrier or worker’s compensation carrier to obtain prior authorizations for standard and complex requests such as imaging, non-invasive procedures, sleep studies, etc.
Communication of medical information to the insurance carrier
Completes referral entry for all external referrals into Epic following approved protocols
Coordinates any ancillary testing and obtains any outside records needed for patient appointment.
Demonstrates expert medical knowledge base with the ability to recognize urgent clinical situations
Prioritize referral requests, responding immediately and expediting most urgent requests
Review complex referral requests, evaluate them, and schedule them with the appropriate provider
Works with providers and other clinical staff to establish the best care plan for the patient
Schedules appointments, tests, and surgeries, coordinating appointments, tests, and consults in preparation for surgery or further clinical work-up.
Acquires prior authorizations for different X-rays and scans, which requires detailed filling out of specific request forms with patient’s medical information outside of URMC. It also includes getting prior authorization for surgeries that may require speaking with insurance company nurses and giving specific health information from patients’ records to get approval.
Interacts effectively in carrying out these responsibilities, presenting a positive image for the Division of Thoracic and Foregut Surgery.
Works regularly with URMC patient registration and clinical information systems.
Documents telephone encounters in eRecord, completion/submission of patient care and insurance documents.
Coordinates maintenance of patient records, documentation for billing, and completion/submission of documents regarding patient care and insurance.
Transcribes proofreads and ensures accuracy and timeliness of all written materials, including medical reports and correspondences.
Demonstrates knowledge of medical terminology, word processing, spreadsheets, and presentation software.
Researches hospital medical records for the information requested by physicians, insurance companies, and attorneys.
Occasionally composes, takes minutes, types, and signs nonroutine correspondence providing factual information.
Assists in managing all incoming mail for surgeon(s) and nurse practitioner(s), assuring that all correspondence receives timely attention and is followed up appropriately.
Assists with training incoming new secretaries or temporary secretaries when requested.
Functional knowledge of various office equipment.
Provides coverage for absences within the division, off-site practice location if needed, and within the department when requested.
Other duties as assigned