PATIENT VISIT SPECIALIST - ORAL MAXILLOFACIAL

Company: Presbyterian Hospital (Albuquerque, N.M.)
Location: Albuquerque
Posted on: January 13, 2022

Job Description:

• Performs visit closure activities to coordinate patient care while providing an exceptional patient experience for successful completion of next steps ordered by the clinician
• Advanced scheduling for specialty or radiologic proceduresRecognizing payor requirements and obtaining prior authorization/certification/referrals for visits/proceduresProcesses daily referral workqueues for authorization, deferring only those that require payor consideration
• Primary Care and most Specialty Care offices must process STAT and ASAP referral workqueues for results received
• Return scheduling knowledge to include the ability to scrub schedules for accuracy and efficiency in home department
• Monitor in-baskets and reports for overdue results, waitlisted appointments, recalls, etc Responsibilities Responsibilities:Customer Service and Caring Practices:* Achieve exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools. * Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times * Ability to manage conflict and appropriately request the help of a supervisor when needed * Fosters effective patient relations with patients, the public and providers by listening, responding and escalating when appropriate * Round with patients waiting to insure their comfort and to inform of delays when applicable Encounter Components: * Review and follows order entered into the EHR by the clinician * Schedule return visits lab, radiology, STAT & ASAP appointments and advanced imaging * Obtain Prior Authorization/Referral per payor protocols * Validates patient MyChart Access * Prints AVS as applicable with double check for HIPAA privacy * Collects any backend patient balance such as high deductible * Communicates effectively to ordering clinician when any restriction, such as access, restricts or prohibits scheduling as ordered Financial Accountabilities:* Refers as appropriate to on site Financial Advocate, or for uninsured to the Financial Advocacy Center * Validate prior authorization/certification/referral are secured PRIOR to a scheduled procedure or test, alerting stake holders (patient, patient representative, OR, etc) if a breakdown occurs Message Management: * Formulates complete and accurate telephone encounter messages and routes to the appropriate Epic in-basket pool to support operational aspects of patient care. Medical Record Components: * Instructs patients on the Release of Information process and insure a fully completed ROI Form is submitted to Health Information Management for incoming or outgoing records Patient Relations* Comprehend quality service connection to patient satisfaction and reimbursement * Participate in metric goals for telephones performance metrics, TSF and abandonment rate when applicable * Perform confirmation calls when applicable to include directions and instructions as required by the visit type Patient Safety* Respond quickly to patients showing distress. Follow guidelines set forth by the Clinic Manger to alert the clinical team. Assist in any manner the clinic team directs. * Ensure check out area, waiting area and walkways are clear of any unnecessary items and are clean and neat. * Report any concern that may create a safety issue. * Annual competency completion of Clerical Staff during a Code Blue Quality Improvement: * Appointment reminder calls * Rescheduling * Evaluate provider schedules and take appropriate action to ensure accuracy and efficiency per guidelines * Works with assigned physicians to maximize schedule effectiveness C.A.R.E.S Behaviors: * Demonstrates CARES behaviors of Collaborate, be Accountable, Respect, Engage and Serve to all whom you encounter. Qualifications Academic Preparation: *High school or equivalent *Short-term training in Medical Terminology*Familiarity with CPT and ICD-10 coding Experience: *Minimum 18 months experience in a medical office setting with significant MD interaction*Proficiency in prior authorization/certification/referral process*Must pass EPIC competency for Registration at completion of Epic Clerical Training class Professional Requirements: *Pass annual competency exam for all areas of responsibility.*Attend Quarterly MSO meetings.*Attend Staff meetings*Attend Employee Forums Abilities: *Requires strong organizational and multi-tasking skill sets*Significant customer service skill set paramount*Must be able to function under pressure while maintaining professionalism*Working knowledge of CPT and ICD-10 coding *Pass annual competency exam for all areas of responsibility.*Attend Quarterly MSO meetings.*Attend Staff meetings*Attend Employee Forums Benefits Benefits are effective day-one (for .45 FTE and above) and include:
  • Competitive salaries
  • Full medical, dental and vision insurance
  • Flexible spending accounts (FSAs)
  • Free wellness programs
  • Paid time off (PTO)
  • Retirement plans, including matching employer contributions
  • Continuing education and career development opportunities
  • Life insurance and short/long term disability programs About Us Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system ofnine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees.AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Keywords: Presbyterian Hospital (Albuquerque, N.M.), Albuquerque , PATIENT VISIT SPECIALIST - ORAL MAXILLOFACIAL, Other , Albuquerque, New Mexico