Patient Services Coordinator III at Careerbuilder in Boston, Massachusetts

Posted in Other 12 days ago.





Job Description:

GENERAL SUMMARY/ OVERVIEW STATEMENT:



Under the direction of the Administrative Manager, incumbent will be a part of the Neurology Access Center for new patients. This person will receive incoming phone calls and online requests from both patients and referring providers interested in accessing care at MGH in the Department of Neurology, perform new patient intake and complete scheduling processes. The key role of the Patient Service Coordinator is to ensure that patients, referring providers and other customers receive timely, efficient and high-quality service. This is a telephone-based position; there is no face-to-face interaction with patients or other customers.



PRINCIPAL DUTIES AND RESPONSIBILITIES:




Principle Responsibilities



  • Functions as the key representative of the department to initiate and coordinate new patient intake and scheduling

  • Documents all patient demographic, medical, financial, and referral information into the computer in strict compliance with established department procedures for the purpose of verifying new patient information before scheduling an appointment.

  • Partners with the Division of Comprehensive Neurology to schedule new patient appointments.

  • Proactively reviews physician schedules to ensure efficient utilization of available clinic time and backfills cancelled appointments as needed.

  • Answers telephone, triages calls, takes accurate and detailed messages using professional and courteous customer service techniques.

  • Provides basic information and instructions to patients regarding the practice and the Hospital. Arranges for transport, interpreter and other services as required by the patients.

  • Obtains all patient information required by the providers prior to an appointment. Ensures that the medical records are available to all health care providers.

  • Provides excellent customer service to both internal and external customers of the Massachusetts General Hospital ambulatory practices; supports ongoing communication and provides service recovery when needed with patients and referring physicians

  • Maintains confidentiality and privacy consistent with HIPAA guidelines.

  • Keeps supervisor informed of issues, especially as they relate to the interaction of the department with other areas of the hospital.

  • Provides cross coverage as necessary

  • Performs other duties as assigned.


Referral & Authorization Specialist Responsibilities



  • Regularly attends Payer Communications Forum Meetings with Billing Manager and reports back any relevant information to departmental leadership.

  • Presents on Prior Authorization challenges with specific Payers at Quarterly All Staff Meetings.

  • Creates presentations, resources and provides training to fellow staff members.

  • On-boards new staff to insurance resources and issues. Coaches and trains administrative support staff on policy changes with the Payers (share by MGPO support), identifies patterns and objections from specific Payers and formulates strategies to overcome them.

  • Serves as a resource to other PSCs on complicated authorization and referral matters.

  • Identifies trends and patterns with payer policies and behaviors and communicates and escalates these issues to departmental leadership.


Required Competencies
:




Service Excellence


  • Demonstrates a commitment to the MGH Mission, Statement of Behaviors, and department service vision.

  • Enthusiastically connects with a diverse population of patients, caregivers and colleagues.

  • Prioritizes work in alignment with the needs of the patients, family members, caregivers and colleagues.

  • Ability to maintain a high level of professionalism in handling all situations diplomatically and courteously.

  • Consistently maintains a comfortable, clean and safe setting.

  • Adheres to department dress policy.

  • Ability to maintain confidential medical information.



  • Attention to Detail


  • Adheres to assigned schedules to ensure appropriate staffing coverage.

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

  • Receives and responds to internal and external telephone calls from patients, caregivers, coworkers and other departments.

  • Schedules new, follow-up, same day, annual and diagnostic patient appointments.

  • Responsible for collecting patient co-payments in accordance with the Co-payment Collection Policy.



  • Communication


  • Demonstrates strong verbal and written skills.

  • Provides accurate information and clear explanations regarding appointment requirements, instructions and policies and procedures.

  • Adapts communication style to varying customer needs.

  • Employs active listening skills.



  • Collaboration & Teamwork


  • Exhibits diplomacy and communicates with others in a manner that demonstrates respect, professionalism and a commitment to the team.

  • Offers and seeks assistance to and from coworkers that support the team and ensures that patient needs are not compromised.

  • Provides cross coverage during unexpected and scheduled absences.

  • Participates in department initiatives and contributes to the team's success.

  • Acts as a liaison between key departments, providers and coworkers.

  • Assists in mentoring new staff as directed.



  • Flexibility & Resilience


  • Demonstrates flexibility and adapts to shifting priorities in response to the needs of patients, caregivers and colleagues.

  • Responds to change with a positive attitude and remains open-minded.

  • Demonstrates ability to rebound quickly when confronted with challenging situations.

  • Demonstrates a willingness to learn.



  • Pro-active Problem Solving and Follow-Through


  • Demonstrates ability to make sound decisions and take appropriate action.

  • Utilizes available resources and recognizes when a situation warrants assistance.

  • Identifies trends and opportunities for improvement.





  • Qualifications

    QUALIFICATIONS:





    • Minimum required education is high school diploma and/or GED equivalent. Some college preferred.

    • Must have vast experience with the Prior Authorization process for both evaluation and management encounters as well as the ordering of tests, labs, procedures, etc.

    • A minimum of 1-2 years in a clinical setting, including a basic knowledge of medical terminology.

    • Basic computer skills, including demonstrated ability to effectively use of Microsoft Outlook and Excel required

    • Epic experience strongly preferred

    • Prior customer service work experience, specifically in a contact/call center environment strongly preferred




    WORKING CONDITIONS:



    Ambulatory Care Setting



    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.