GENERAL SUMMARY/ OVERVIEW STATEMENT:
Under the direction of the practice manager, the Patient Services Coordinator III functions within the ambulatory practice coordinating administrative, research, and academic functions for a complex surgical with supporting administrative responsibilities. Assists with the effective management of the surgeon’s daily operations.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
· Perform all duties and responsibilities of a PSC I and II:
· Schedules patient office appointment using Epic including scheduling for more than one facility; coordinates appointments with those of other consulting physicians or primary care physician as appropriate.
· Registers new patients over the telephone or on day of appointment, obtaining all necessary information in a courteous manner; creates office medical records for new patients; follows-up prior to patient appointment to ensure that patient is registered in Hospital Patient Care Information System.
· Retrieves medical records prior to patient office hours; ensures that all necessary laboratory and radiological test results and medical records are received from within and outside of MGH, and properly filed prior to patient’s office visit; is knowledgeable in the use of computer applications needed to obtain above information.
· Distributes patient information, maps, etc. prior to patient appointments.
· Answers patient/family questions regarding appointments, surgical procedures, and pre-operative instructions as appropriate.
· Arranges for interpreter services as needed prior to patient appointment.
· Places reminder telephone calls to patients 1-2 days before scheduled office visits.
· Places reminder telephone calls to patients 1-2 days before scheduled surgical procedures.
· Prints and prepares encounter forms for patient office hours and surgeries.
· Ensures that all demographic data in patient medical record is current, complete, and validated.
· Consistently ensures that referral forms are obtained from patients or primary care physician’s office prior to patient’s office visit.
· Schedules follow-up appointments and laboratory or radiology testing in a timely and courteous manner; prepares appropriate requisition/paperwork and arranges for specimen retrieval as necessary; ensures that any necessary follow-up is scheduled at the appropriate time in the future.
· Schedules surgeries, pre-admission testing, and admissions; completes, delivers, and files all associated paperwork in an accurate and timely manner.
· Is knowledgeable in the use of the MGH OR Scheduling Computer System and troubleshoots as necessary.
· Consistently ensures that patients/family complete Consent for Surgery forms.
· Consistently provides patients/family with copies of surgery instructions for appropriate institution/type of admission.
· Provides patients/family with time of surgery and reviews any pre-surgical instructions in a courteous and timely manner.
· Contacts patients’ insurance companies in a timely manner to obtain pre-certification for surgery as necessary.
· Proofreads, and edits and manages physician’s LMR office notes/consultation letters insuring that letters are sent to referring physician for each patient encounter and within 1-2 days of patient visit.
· Performs billing for physician’s services or ensures that all office/surgical paperwork necessary for billing is accurately photocopied, prepared, and forwarded to the billing service within one week of service;
· Follows-up using PCIS or with physician/residents as necessary to obtain operative reports in a timely manner for billing;
· Performs CPT or ICD-10 coding as required.
· Responds to requests from billing service or third party carriers for information, corrections, etc
· Re-schedules any canceled appointments or surgeries in a timely manner.
· Responds to requests from physicians’ offices, family, or government agencies for letters of medical necessity, letters to schools, copies of medical records, etc. as necessary.
· Updates spreadsheet / database of surgical procedures performed on a weekly basis according to requirements of physician.
· Prepares and sends follow-up visit reminder letters to patients in a timely manner.
· Retrieves and returns hospital medical records for physicians for research, signature, billing, etc. as needed.
· Contacts Emergency Department and surgical residents as appropriate to provide information regarding patients arriving in Emergency Department as necessary.
· Coordinates the scheduling of multiple appointments using multiple systems or resources.
· Investigates and resolves issues relating to and arising from the referral and/or billing process, which interrupts the delivery of care to a patient or the reimbursement for services rendered. Addresses patient questions, complaints and concerns.
· Possesses a thorough knowledge of all HMO, managed care, other third party insurers, and available patient financial services/resources.
· Assists in resolving identified issues, working collaboratively with practice management. Implements resolutions.
· Coordinates complex workflow and multiple schedules for surgeon to insure an efficient daily operation. Troubleshoots workflow issues as needed.
· Assists with special projects as required. Projects may include such topics as obligations to insurers, hospital issues of compliance and/or Operations Improvement Initiatives.
· Schedule meetings, conference calls and appointments surgeons as requested.
· Special projects as assigned by Practice Manager, Director and / or Division Chief.
· Minimum of 5 years work experience in medical group practice, billing and/or managed care setting required.
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
· Demonstrated experience to interface with various levels of the practice, especially with the knowledge and issues related to manage care.
· Thorough knowledge of Epic system modules and its features, electronic medical record modules and transition to Book It with all system features, as applicable.
· Demonstrated ability to work independently, with limited supervision, resolve issues, be organized, attentive to detail and achieve outcomes within the team.
· Demonstrates effective interpersonal and communication skills.
· Effectively interacts with all levels of management.
· Demonstrates knowledge of HIPAA Confidentiality and Privacy policies.
· Demonstrates an understanding of Disaster protocols to include: fire, safety, code calls, per the mandatory training, as outlined by MGH and JCAHO guidelines.
Additional client information: