Customer Service Specialist- Periop Surgical Home (Full Time/Day Shift)

Summary

Job Description

HOURS: 40/hrs/wk- Monday through Friday, no weekends, no call.  all 8 hour shifts starting at 0700, 0730, 0800, and 0830. 

POSITION SUMMARY: Provides complete and accurate patient scheduling, registration, insurance verification, ordering of tests and coordination of applicable screening, diagnostic, physician office and outpatient hospital services.  Capable of coordinating and communicating effectively during increased volumes or with complex patients.

ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:

• Performs complete and accurate patient registration including but not limited to: walk in, check-in, and/or scheduled.
• Demonstrates ability to successfully adapt and perform during times of high volumes and/or high patient acuity.  Demonstrates skill to service both hospital and physician office patients, as assigned. 
• Supports inbound and outbound calls to or from patients, guests, or appropriate parties to provide services. Effectively manages general patient complaints/concerns in a professional manner, escalating more complex issues to supervisor/manager as needed.
• Understands and supports Point of Service Collections. Performs all necessary functions needed to collect patient obligations.
• Refers patient to appropriate person for questions regarding; collections, insurance coverages, and financial assistance.
• Disseminates or discusses information with the patients regarding co-pays, out of pocket expenses, pre-appointment preparation, arrival times, etc.
• Verifies patient, guarantor, coverage and hospital account information. Performs required referral/authorization processes and enters orders for applicable tests. 
• Understands insurance company coverage and referral/authorization requirements of payors.  Performs electronic and manual verification of insurance coverage and understands how to read and accurately apply electronic insurance responses.
• Prepares and/or releases records or orders in the e-Health record. Scans all necessary documents into appropriate medical record. Understands the importance of patient’s medical information that is documented on paper. Sends all pertinent information to document imaging or heath information management team with in the established time frames.
• Completes documentation for compliance and regulatory needs and/or release of orders. Retains knowledge and abides by all regulatory requirements pertaining to duties of position and overall operations (as applicable).  
• Screens and accurately relays messages using protocols established for emergent, urgent and non-urgent calls.
• Demonstrates ability to register unscheduled patients requiring a full financial clearance.
• Completes assigned patient scheduling and registration work queues according to performance standards. 
• Ability to resolve work queue issues and missing registration items via electronic medical record. 
• For LGHP, this role may necessitate occasional regional travel.

JOB REQUIREMENTS

MINIMUM REQUIRED QUALIFICATIONS:

• High School Diploma or equivalent (GED).
• One (1) year of clerical, customer service, or administrative support experience in a highly customer-oriented organization.
• One (1) year experience with basic keyboarding, personal computer use, and other office setting equipment.
• For Regional Positions only – Valid driver’s license is required.

PREFERRED QUALIFICATIONS:

• One (1) year of registration experience, point of service collection, insurance validation, understanding of compliance /regulatory guidelines and order release process(es).
• One (1) year prior experience of Revenue Cycle in a Hospital/Medical Office Setting.
• Previous Epic or equivalent Electronic Medical Record experience.

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