Precertification Coord Lead

The Ohio State University

About The Position

The Revenue Cycle for The Ohio State University Wexner Medical Center provides customer service while processing patient demographic and insurance information efficiently and accurately. Revenue Cycle functions include pre-registration, registration, pre-certification, financial clearance and counseling, financial assistance, scheduling, billing, claims follow-up, customer service, and cash collection. Its primary responsibility is to ensure collection of net revenue for services rendered. The Patient Access Coordinator Lead is an expert in a product, process, or service-line area, such as physician appointment scheduling, OR/admission, full-service scheduling, pre-registration and registration, insurance verification, or patient-liability determination and communication. The position provides clinical staff and patients with accurate, current information about products, services, and general procedures. It schedules return or other appointments as assigned; gathers accurate appointment, demographic, and insurance information; coordinates requests from physicians and consumers; and resolves routine and complex customer problems. The role communicates regularly with clinical staff, medical secretaries, and product/service-line staff to meet customer and department needs, and helps create a positive first impression. The lead uses a variety of software, including the electronic medical record, scheduling and registration systems, ABN, eligibility, and document-management software. The position also orients new staff and student interns, teaches department standards, policies, and procedures, and provides feedback as needed. Ongoing responsibilities include maintaining competency and system proficiency, keeping current with product/service-line information and relevant policies and procedures, meeting mandatory education and health requirements, and attending required in-services, education forums, and meetings.

Requirements

High school diploma or GED.
PC knowledge and interpersonal, verbal, and written communication skills.
At least 6 months of experience in customer service or a healthcare environment.
Four years of relevant experience required.
At least 2 years of experience in a healthcare setting, existing revenue cycle department, or customer service role.
Ability to use Windows, Excel, intranet/internet navigation tools, and system content.
Ability to work in multiple systems for assigned tasks, management, and reporting.
Strong problem-solving and presentation skills.
High level of customer service skills.
Ability to prioritize and coordinate multiple tasks in a busy environment.
Maintain competency in daily functions and interpersonal and cognitive skills required for essential job functions.
Maintain proficiency in applicable systems and meet mandatory educational, health, scheduling, and registration requirements.

Nice To Haves

Six or more years of relevant experience.
Associate degree in a relevant field.
Certification or vocational training may be required.
Medical terminology, coding, and third-party reimbursement experience.

Responsibilities

Provide accurate, up-to-date information to clinical staff and patients regarding products, services, and general procedures.
Schedule return appointments and other appointments as assigned.
Gather accurate appointment, demographic, and insurance information to support clinical and financial needs, including updates to insurance and other patient information.
Coordinate physician and consumer requests and satisfy their needs in one transaction.
Resolve routine and complex customer problems and direct customers to the appropriate resource for specific questions.
Communicate regularly with clinical staff, medical secretaries, and product/service-line staff to meet customer and department needs.
Use applicable electronic medical record, scheduling, registration, ABN, eligibility, and document-management systems.
Orient new staff and student interns; educate them on department standards, policies, and procedures and provide feedback as necessary.
Maintain competency in daily functions and proficiency in applicable systems.
Maintain knowledge of product/service-line information, quality improvement, cost reduction, registration and billing policies and procedures, and scheduling policies and procedures.
Meet mandatory educational and health requirements and ongoing scheduling and registration competencies.
Attend Health System and departmental in-services, education forums, and meetings as required.