Medical Office Access Coordinator (FT)

Webster, TX United States

JOB SUMMARY

Responsible for coordinating verification of benefits prior to procedures and determining appropriate site of service for all requested services. Coordinates and maintains working relationship with office staff to ensure maximum efficiency and prompt communication with patients and staff. Maintains information in an organized manner and obtains pre-authorization for procedures as required by the insurance companies.

Reviews financial obligations with patient and/or family members. Responsible for sending proper documentation to billing department.  Prequalifies third party coverage of scheduled procedure. Creates and maintains reconciliation process for weekly communication with office staff and Administration.

Reports: Business Office Supervisor

Supervises: None 

QUALIFICATIONS

High School graduate required

Four years of medical facility or medical business office experience required

Cath Lab experience required 

Experience in customer relations or teaching preferred

Experience in third party payer requirements preferred

Automated billing systems experience required

Training/experience in business office activities preferred

Requires frequent and constant judgement for timely response to patient questions and concerns.

Requires language skills adequate for effective written and interpersonal communication in American English.

Require visual and auditory acuity adequate for frequent use of computers and occasional use of other business office equipment.

Ability to sit for long periods and to perform desk and office activities.

OCCUPATIONAL EXPOSURE

Category III exposure to bloodborne pathogens may encounter chemical hazards.

RESPONSIBILITIES

  1. Input Referral Coordinator

    1.1 Receives all orders via fax, email, and Physicians Systems.

    1.2 Creates patient in Savance and assigns patient to designated coordinator.

    1.3 Responsible for reconciling patient account once scheduled.

  2. Communication Responsibilities to include, but not limited to:

    2.1 Provides documentation for surgical and special procedure patients.

    2.2 Maintains current materials for patient education and consent procedures.

    2.3 Discusses documentation with patient and family member confirming that instructions are understood and questions answered.

    2.4 Answers patient and family member questions and refers questions to healthcare professionals when appropriate.

    2.5 Communicates pertinent information from the physician, support staff, insurance companies and other significant parties to the patient.

    2.6 Reports regularly to the Business Office Supervisor about the status of current projects or workflow.

    2.7 Reviews prequalification for third party payer before date of scheduled admission.

    2.8 Ensures that procedures are scheduled timely and that confirmation of the appointment is verified.

  3. Counsels patients about Facility charges, Physician charges, and insurance coverage and the intra-operative experience.

    3.1 Discusses financial obligations with the patient or family member, explaining the fees and reimbursement process.

    3.2 At patient request, provides a written explanation of estimated fee schedules prior to surgery and documents it in the patient's medical record.

    3.3 Determines patient qualification for coverage by third party payer and informs patient or family member of status; if patient is not covered, arranges for payment.

    3.4 Assists in planning a payment schedule for the patient.

    3.5 Assists in planning and coordinating patient care with multiple facilities and locations.

    3.6 Completes data entry of patient cost sheets, if applicable.

     3.7 Reviews forms for patient signature; obtains forms or signature(s) as needed.