Patient Services Coord. II at Careerbuilder in Lexington, Massachusetts

Job Description:

GENERAL SUMMARY/OVERVIEW STATEMENT:



The Patient Services Coordinator II,under general supervision, provides administrative support to health careproviders in a high-volume ambulatory setting, functioning as the primaryinterface between the patient and the providers. The emphasis is placed on theability to organize priorities, complete tasks, manage confidential patient information, schedule patient appointments, and manage referralsand other managed care related issues, such as medication and insuranceauthorizations. Serves as an overallresource person for support staff.


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



PRINCIPAL DUTIES ANDRESPONSIBILITIES:



Performs all duties that are theresponsibility of a Patient Service Coordinator I and able to support otherPSCII positions. Cross coverage acrossadministrative positions is expected so training of standard responsibilitiesfor each position is provided.


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


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


Performs the daily management ofencounter form processing and reconcilement.


Ensures the completeness of all formsand performs basic ICD-9 coding, as required to complete visit encounter formsfor processing


Understands all HMO, Managed Care and otherThird Party Insurers. Functions as a resource for patients around managed careplans, insurance and referral issues, with an ability to perform electronicinsurance verification.


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


Under the direction of the practicemanager, functions as a department resource for referral, authorization, andinsurance issues, including but not limited to medical, neuropsychologicaltesting, medication prior authorizations and mental based insurance priorauthorizations. Remains current on thechanging issues impacting the health care insurers.


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


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


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


Completely performs and is a resourceto other team members in all revenue enhancement activities, including but notlimited to registration verification, co-payment collection, cash management,encounter form reconcilement, etc.


Coordinates the scheduling ofdiagnostic testing.


Coordinates and tracks referralappointments and visits.


Provides cross coverage for otherPractice staff members for absences, vacations, etc. and during variations inworkflow, as needed


Assists with training and orientationof new staff, where applicable.


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


Works on special projects as directed.



Qualifications

QUALIFICATIONS:



High School Degree Required.Associate's Degree in Secretarial Science/Business, or a Secretarial TrainingCertificate Program strongly preferred.


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



SKILLS/ ABILITIES/COMPETENCIES REQUIRED:



Knowledge of computer skills necessaryto use appropriate modules of EPIC Cadence, and electronic medical record modulesas 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 withina team environment


Excellent and effective interpersonaland communication skills


Demonstrated ability to workeffectively and courteously with various groups of patients, staff andproviders.


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


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


Demonstrated knowledge of HIPAAConfidentiality and Privacy Policies


Demonstratedunderstanding of Disaster protocols to include: fire, safety and code calls, per the mandatory training, asoutlined by MGH and Joint Commission guidelines.



EEO Statement

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.