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Patient Services Rep II-Behavior & Development at Nemours in Wilmington, Delaware

Posted in General Business 30+ days ago.

Type: Full-Time





Job Description:

Primary Function:

Greets families according to Nemours Standards of Behavior and AIDET. Check-in/out patients for scheduled appointments, collects accurate demographic/insurance information and documents in the system, verify insurance eligibility, review copay and account balances, collect funds as needed, schedule appointments, make outbound scheduling/appointment and confirmation calls, complete administrative work as assigned

Essential Functions:

  • Greets families according to Nemours Standards of Behavior and AIDET
  • Accurately load/update patient demographics adhering to system warnings
  • Accurately schedules patients and creates/completes referral shells according to Scheduling Reliable Method
  • Submit electronic referral requests at time of scheduling
  • Obtain/understand insurance information provided by callers and accurately load insurance into EPIC
  • Understand how to read electronic response history to enter/update insurance changes in EPIC, i.e. co pays, capitation agreements, PPO plan vs. HMO plan, coverage effective dates etc.
  • Make outbound calls to families to provide accurate insurance eligibility information for service requested and collect any prepayment/deposit fees for scheduled visits for requested service, i.e. collect OON/NONPAR deposits required prior to DOS
  • Informs patients about current initiatives, i.e. online scheduling, evening clinics and telehealth appointments
  • Reviews essential patient appointment information, i.e. location of appointment, Nemours APP (telehealth), bring all meds to appt., prep information, etc.
  • Process requests for prescription refills
  • Documents DAR notes were applicable
  • Confirms referral requirements with caller
  • Participate in daily huddles.
  • Manages the CCR template exceptions work which includes cancelling, rescheduling and blocking provider templates as requested via the CCR ticket process.
  • Manages the internal and external referral work queues.
  • Manages the PCP ticket requests to verify and update PCP information for EPIC.
  • Processes and completed incoming e-Referral external physicians requests for appointment scheduling.
  • Processes incoming staff messages by supporting the Nemours APP website and the Access Center team.
  • Works according to the Standard Reliable Method
  • Offers process improvements opportunities via the daily huddle
  • Completes mandatory in-service training yearly which includes but not limited to safety, infection control, HIPAA, corporate compliance, and bioterrorism
  • Assist with making discharge follow up calls
  • Knowledge and adherence to all Joint Commission Guidelines

  • Additional Requirements:

    High School Diploma

    1-3 years of patient check in experience required

    Shift: Monday thru Thursday 10:30am - 7:00pm
    Friday 9:00am - 5:30pm





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