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Patient Services Coord. II at Massachusetts General Hospital (MGH) in Lexington, Massachusetts

Posted in Other 28 days ago.

Type: Full Time





Job Description:

GENERAL SUMMARY/ OVERVIEW STATEMENT:

The Patient Services Coordinator II, under general supervision, provides administrative support to health care providers in a high-volume ambulatory setting, functioning as the primary interface between the patient and the providers. The emphasis is placed on the ability to organize priorities, complete tasks, manage confidential patient information, schedule patient appointments, and manage referrals and other managed care related issues, such as medication and insurance authorizations. Serves as an overall resource person for support staff.

This is a 40 hour, Monday through Friday position. Standard hours are from 8:30 5:00PM.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Performs all duties that are the responsibility of a Patient Service Coordinator I and able to support other PSCII positions. Cross coverage across administrative positions is expected so training of standard responsibilities for each position is provided.

Performs all check-in and -out functions, as outlined by the MGH/MGPO Front Desk Standards of Operations.

Provides support and information to providers to problem solve and manage complex administrative patient issues

Performs the daily management of encounter form processing and reconcilement.

Ensures the completeness of all forms and performs basic ICD-9 coding, as required to complete visit encounter forms for processing

Understands all HMO, Managed Care and other Third Party Insurers. Functions as a resource for patients around managed care plans, insurance and referral issues, with an ability to perform electronic insurance verification.

Assists with investigating and resolving issues relating to and arising from the referral and/or billing process, which interrupts the delivery of care to a patient or the reimbursement for services rendered. Addresses patient questions, complaints and concerns.

Under the direction of the practice manager, functions as a department resource for referral, authorization, and insurance issues, including but not limited to medical, neuropsychological testing, medication prior authorizations and mental based insurance prior authorizations. Remains current on the changing issues impacting the health care insurers.

Understands financial services and self-pay resources and provides patients with information as needed.

Triages and manages more complex telephone calls, utilizing courteous customer service skills.

Maintains confidentiality and privacy, which is consistent with HIPAA guidelines.

Completely performs and is a resource to other team members in all revenue enhancement activities, including but not limited to registration verification, co-payment collection, cash management, encounter form reconcilement, etc.

Coordinates the scheduling of diagnostic testing.

Coordinates and tracks referral appointments and visits.

Provides cross coverage for other Practice staff members for absences, vacations, etc. and during variations in workflow, as needed

Assists with training and orientation of new staff, where applicable.

Performs all other related tasks which would facilitate the flow of patients through the practice, or which would enhance the quality of service to patients.

Works on special projects as directed.

QUALIFICATIONS:

High School Degree Required. Associates Degree in Secretarial Science/Business, or a Secretarial Training Certificate Program strongly preferred.

Minimum of 2 years work experience in medical or health care related practice. Billing and/or managed care experience, particularly mental health billing, is preferred.

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:

Knowledge of computer skills necessary to use appropriate modules of EPIC Cadence, and electronic medical record modules as required.

Good command of the English language, including medical terminology

Exceptional organizational skills, flexibility to manage multiple tasks and the accurate attentive to details.

Ability to work independently or within a team environment

Excellent and effective interpersonal and communication skills

Demonstrated ability to work effectively and courteously with various groups of patients, staff and providers.

Demonstrated ability to problem solve and function as a resource to other members of the team, and resolve complex issues on behalf of the providers and the patients.

Demonstrated in-depth understanding of managed care and all other pertinent insurance/medical coverage

Demonstrated knowledge of HIPAA Confidentiality and Privacy Policies

Demonstrated understanding of Disaster protocols to include: fire, safety and code calls, per the mandatory training, as outlined by MGH and Joint Commission guidelines.

Massachusetts General Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. Applications from protected veterans and individuals with disabilities are strongly encouraged.