Practice Representative - Specialty
Department Description: Per Diem position located in Sports Medicine Chestnut Hill. Monday-Friday Day shift hours available.
Job Location: Chestnut Hill, MA
Req ID: 31994BR
Job Summary: Serves as a primary point of contact for patients and visitors in an outpatient unit and provides excellent customer service through clear communication. Coordinates check in and complex scheduling for multiple service areas.
- Performs check in, registration and verification of demographic and fiscal information according to medical center policies and procedures utilizing hospital computer systems. Confirms prior authorizations, referrals for specialty service and pre-certifications for patient's insurance and managed care plan. Collects required co-payments for multiple practices. Directs patients to service areas.
- Coordinates and schedules multiple appointments for follow-up and ancillary services. Maintains current knowledge base of referral and authorization plan rules and process related policies for multiple insurance and managed care payers. Maintains current knowledge base of referral, level of care and number of visits being authorized.
- Gathers complete and accurate information from patients/callers, prioritizing and facilitating communication of information to providers. Prepares schedules, medical records and other documents in accordance with quality standards. Maintains patient confidentiality at all times, whether by phone, in discussion with providers or in distribution of patient information by email, fax, etc.
- Assists patients, other employees and the general public in a courteous, helpful manner by phone and in person. Provides accurate information, directions and/or guidance and follows up promptly to ensure that needs have been met. Explains, as needed, to patients the waiver process and obtains patient signature and attaches waiver to visit ticket.
- Assembles medical records according to regulatory standards as defined by the medical center, The Joint Commission (TJC) and other regulatory agencies. Ensures patient records and relevant documents filed in the record have accurate patient identification. Maintains current knowledge base of referral, level of care and number of visits being authorized.
- High School diploma or GED required. Associate's degree preferred.
- 0-1 years related work experience required.
- One year experience in a healthcare or service/hospitality environment.
- Basic familiarity with computers. Ability to navigate at a basic level within web-based applications.
- Written Communications: Ability to read, and write in English in order to understand basic safety instructions and take direction from supervisors; communicate effectively with patients, families and other medical center staff; and respond to basic questions.
- Oral Communications: Ability to comprehend and converse in English to communicate effectively with medical center staff, patients, families and external customers.
- Knowledge: Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations.
- Team Work: Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, and respecting team members.
- Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.
Physical Nature of the Job:
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally
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