Patient Services Coord. II

Under general supervision, provides administrative support to a physician, medical practice or clinic for patient care and administrative activities. Works with the physician, staff members and management to ensure a quality-based, customer-oriented flow of work. Utilizes discretion and judgment to organize priorities, complete tasks and handle confidential patient information. Performs a wide range of administrative tasks to support a medical office, including schedules patient appointments and diagnostic testing, obtaining referrals and pre-certifications as needed; provides patient reception, prepares consultation letters, notes, and correspondence; performs photocopying, faxing, filing and answering telephones.

I. PATIENT CARE RESPONSIBILITIES

• Answers telephone, triages calls, takes accurate and detailed messages using professional and courteous customer service techniques.
• Schedules patient office appointments using Cadence; may include scheduling for more than one facility; coordinates appointments with those of other consulting physicians or primary care physician as appropriate.
• Prints day sheet for patient office hours and surgeries according to needs of physician; contacts outside institutions for physician office appointment schedule as appropriate.
• Transfers patients to Registration and Referral; may register new patients if needed, 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.
• Refers patients to Patient Financial Services for financial counseling as appropriate.
• Retrieves medical records prior to patient office hours; ensures that all necessary laboratory and radiological test results and medical records are obtained, from within and outside of MGH, and properly filed or scanned prior to patient’s office visit. Ensures records are available for physician needs e.g. signature, billing, etc.
• Maintains knowledge and skill in the use of appropriate electronic systems to obtain and provide information (e.g. Epic). Monitors and uses systems to execute tasks, such as Front Desk Worklist in Epic for incoming and outgoing referrals and Patient Gateway for patient messages.
• Sends appointment confirmations as well as procedure information, such as pre- and post-procedure restrictions, prescription information and insurance waivers to be signed. Distributes patient information. 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 as required.
• Prints, prepares and processes encounter forms for patient office hours and surgeries.
• Checks-in patients as they arrive in a courteous manner.
• Ensures that all demographic data in patient medical record is current and complete, referring patients to Registration and Referral as needed; uses LMR/Cadence as necessary.
• Consistently photocopies patient insurance card when required; ensures copies are filed with billing data as necessary.
• Consistently collects and records patient co-payments or self-payments as required and according to MGPO guidelines. Consistently obtains patient/family signature for billing when needed.
• Consistently ensures referral forms are obtained from patients or primary care physician’s office prior to patient’s office visit; when needed obtains additional forms such as missed referral and missed appointment fee. Coordinates, tracks and decrements referrals as needed.
• Creates and sends no show letters.
• Performs electronic insurance verification using NEHEN Express.
• May prepare or request medical records.

• Coordinates with clinical staff to ensure smooth patient flow.

• Checks-out patients as they exit exam rooms.
• Accurately records information on day sheet according to needs of physician.
• 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.
• Photocopies and files patient-related paperwork (office/operative notes, consultation/medical necessity letters, etc.) in an accurate and timely manner.
• Re-schedules any cancelled appointments in a timely manner and mails cancelled appointment letters to patient.
• Prepares and sends follow-up visit reminder letters to patients in a timely manner. May prepare other patient letters or related correspondence as needed.
• Reconciles encounter forms to the daily schedule, tracks and follows up on outstanding encounter forms. Reconciles end of day cash drawer.
• 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.
• Arranges for internal and external referrals for physician office appointments and schedules as appropriate through internal referral system.
• Obtain preauthorization/predetermination for diagnostic studies and procedures to be submitted to insurance. Input all authorizations into the computer. Resolve any issues and arrange peer to peer review if necessary. Notify patient of any insurance issues and of deductibles, deposits, etc. Educates patients on insurance requirements to avoid delays or difficulties in scheduling procedures and payment of services.
• Send prescriptions to pharmacy or patient and send prescription for compression hose when necessary to patient or DME provider.
• Interacts in a courteous manner with physicians, nurses, and administrative staff within and outside of MGH to coordinate care of patients, obtain referrals, provide feedback, answer questions, etc.

II. ADMINISTRATIVE RESPONSIBILITIES

• Maintains physician’s calendar and coordinates schedule on multiple systems as needed. Schedules appointments and meetings; may arrange conference lines, transportation, travel, etc. if needed.
• Answers telephones and triages complex calls; arranges for forwarding and removal of telephones to answering service; places/returns telephone calls for physician as requested.
• Arranges for payments, e.g. invoices and reimbursement, as needed.
• Performs photocopying, faxing, filing as requested.
• May order office supplies and forms, postage, etc. as needed.
• Retrieves articles from libraries when requested by physician.
• Establishes and maintains databases for storage of records, patient lists, mailing lists, etc. according to physician’s needs.
• May prepare various forms, applications, schedules, patient lists, presentation materials and other documents as needed; retains accurate records and distributes as needed.
• May coordinate visits and schedules for medical students or others to the practice.
• Cross covers other staff members, e.g. breaks, lunches, vacations, during variations in work flow as needed.
• Participates in periodic staff meetings or other departmental meetings.
• Maintains confidentiality and privacy consistent with HIPAA guidelines.
• Performs additional tasks to facilitate the flow of patient or enhance the quality of service to patients. Participates in special projects as may arise from time-to-time.

• Secretarial Certificate or Associate’s Degree. Equivalent and additional secretarial/administrative experience may be considered in place of education.
• Minimum of 2 to 4 years of secretarial experience. Experience in a healthcare setting helpful.

• Exceptional computer skills (including word processing, database, electronic mail, internet, and spreadsheets) required. Knowledge of Epic, Cadence and other systems at a level sufficient to perform job.
• Good command of English language, including medical and scientific terminology.
• Exceptional organizational skills and the flexibility to handle multiple tasks and deadline pressures.
• Ability to work independently or in a team environment.
• Excellent interpersonal and customer service skills; ability to solve problems.
• In-depth understanding of all pertinent medical insurances, managed care and patient financial services.
• Is knowledgeable and compliant in all hospital, State and Federal regulatory requirements, including hospital policy and procedures (where applicable to the performance of the job), Joint Commission (JC), and Health Insurance Portability and Accountability Act of 1996 (HIPAA).

• Normal office conditions.