Address
Form of workJob Type
Full-time
Description
Summary
Ensures that all patients with Insurance are verified and accurate information is
collected to ensure accuracy during patient check in. Ensures the patient demographics are
correct before patient's appointment
Requirements
Essential Duties and Responsibilities include the following. Other duties may be assigned.
Insurance Verification
Runs schedules for all physicians twice each day, reviews for accuracy and reports
inaccuracies to Clinic Manager
Verifies the insurance of each patient using Rycam, Payer Gateway, TMHP, Availity or
individual insurance website; calling insurances when necessary to determine copays and
or deductibles
Documents all necessary information in the MPI Insurance Tab, and the appointment
screen as necessary for accurate patient check in
Ensures patients have the correct PCP listed on insurance policy; initiates referral process
from PCP to treating physician when necessary
Scheduling
Takes incoming calls regarding clinic and outpatient procedures; makes outbound
calls to patients for appointment confirmation as back up to the scheduling team.
Interviews patient or representative to obtain and record name, address, date of
birth, emergency contacts, attending provider, and individual or insurance
company responsible for payment of bill
Explains clinic regulations such as payment of services, fee schedule and clinic
procedures
Enters patient admitting information into computer and books appointments
Ensures the speaker is the patient or legal guardian when necessary
Compiles data for census records
Manage and resolve customer complaints
Route calls to appropriate destination
Follow up patient calls when necessary
Completes Call Logs
Monitors the day to day productivity of the Scheduling Department.
Supervisory Responsibilities
This job has no supervisory responsibility
Competencies
To perform the job successfully, an individual should demonstrate the following
competencies:
Design- Demonstrates attention to detail
Problem Solving- Gathers information skillfully
Project Management- Communicates changes and progress
Technical Skills- Pursues training and development opportunities; shares expertise
with others
Customer Service- Manages difficult or emotional customer situations; Responds
promptly to customer needs; Solicits customer feedback to improve service;
Responds to requests for service and assistance; Meets commitments; Listens to
caller intently
Interpersonal Skills- Focuses on solving conflict, not blaming; Maintains
confidentiality; Listens to others without interrupting; Keeps emotions under
control; Remains open to others' ideas and tries new things
Oral Communication- Speaks clearly and persuasively in positive or negative
situations; Listens and gets clarification; Responds well to questions; Demonstrates
group presentation skills; Participation in meetings
Written Communication- Writes/types clearly and informatively; Able to read and
interpret written/typed information
Teamwork- Gives and welcomes feedback
Leadership- Accepts feedback from others
Quality Management- Looks for ways to improve and promote quality;
Demonstrates accuracy and thoroughness
Ethics- Treats people with respect; Keeps commitments; Inspires trust of others;
Works with integrity and ethically; Upholds organizational values
Organizational Support- Follows policies and procedures; Completes
administrative tasks correctly and on time; Supports organization's goals and
values; Benefits organization through outside activities; Supports affirmative
action and respects diversity
Judgment- Exhibits sound and accurate judgment; Makes timely decisions
Planning/Organizing- Prioritizes and plans work activities; Uses time efficiently
Professionalism- Approaches others in a tactful manner; Reacts well under
pressure; Treats others with respect and consideration regardless of their status or
position; Accepts responsibility for own actions; Follows through on commitments
Quality- Demonstrates accuracy and thoroughness; Looks for ways to improve and
promote quality; Applies feedback to improve performance; Monitors own work to
ensure quality
Quantity- Completes work in a timely manner; Works quickly
Safety and Security- Observes safety and security procedures; Determines
appropriate action beyond guidelines; Reports potentially unsafe conditions; Uses
equipment and materials properly
Adaptability- Adapts to changes in the work environment; Changes approach or
method to best fit the situation; Able to deal with frequent change, delays, or
unexpected events
Attendance/Punctuality- Is consistently at work and on time; Ensures work
responsibilities are covers when absent; Arrives at meetings and appointments on
time
Dependability- Follows instructions, responds to management direction; Takes
responsibility for own actions; Keeps commitments; Commits to long hours of
work when necessary to reach goals; Completes tasks on time or notifies
appropriate person with an alternate plan
Initiative- Undertakes self-development activities; Seeks increased responsibilities;
Looks for and takes advantage of opportunities; Asks for offers help when needed
Innovation - Displays original thinking and creativity; Meets challenges with
resourcefulness; Generates suggestions for improving work; Develops innovative
approaches and ideas; Presents ideas and information in a manner that gets others'
attention.
HIPPA Compliance- Maintains the highest level of privacy with patient
information
Motivation - Sets and achieves challenging goals; Demonstrates persistence and
overcomes obstacles
Supports and explains reasoning for decisions.
Qualifications
To perform this job successfully, an individual must be able to perform
each essential duty satisfactorily. The requirements listed below are representative of the
knowledge, skill, and/or ability required. Reasonable accommodations may be made to
enable individuals with disabilities to perform the essential functions.
Education and/or Experience
One year certificate from college or technical school; or three to six months related
experience and/or training; or equivalent combination of education and experience.
Language Skills
Ability to read and interpret documents such as safety rules, operating and maintenance
instructions, and procedure manuals. Ability to write routine reports and correspondence.
Mathematical Skills
Ability to calculate figures and amounts such as discounts, interest, commissions,
proportions, percentages, area, circumference, and volume. Ability to apply concepts of
basic algebra and geometry.
Reasoning Ability
Ability to apply common sense understanding to carry out instructions furnished in written,
oral, or diagram form. Ability to deal with problems involving several concrete variables
in standardized situations.
Computer Skills
To perform this job successfully, and individual should have knowledge of electronic data
entry software, internet software, and Word Processing software. Knowledge of Insurance
Verification programs and reading results accurately.
Physical Demands
The physical demands described here are representative of those that must be met by an
employee to successfully perform the essential functions of this job. Reasonable
accommodations may be made to enable individuals with disabilities to perform the
essential functions.
While performing the duties of this Job, the employee is regularly required to talk and hear.
The employee is frequently required to sit; use hands to finger, handle, or feel and reach
with hands and arms. The employee is occasionally required to stand; walk; stoop, kneel,
crouch. The employee must frequently lift and/or move up to 50 pounds. Specific vision
abilities required by this job include close vision, distance vision, color vision, peripheral
vision, depth perception and ability to adjust focus.
Work Environment
The work environment characteristics described here are representative of those an
employee encounters while performing the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to
perform the essential functions. The noise level in the work environment is usually
moderate.
The incumbent must fulfill the performance of standards of this position and comply with
the policies, rules and procedures of the System, facility and department.
