Job Details
Job Location: Amberwell Atchison - Atchison, KS 66002
Position Type: Full Time
Education Level: High School
Travel Percentage: None
Job Shift: 8 Hour Day
Job Category: Patient Finance
JOB DESCRIPTION:
- Prior authorization and centralized scheduler are key members of the team.
- The scheduler will work under the direction of the Director of Patient Access.
- The prior authorization/centralized scheduler position will be responsible for scheduling patients, obtaining prior authorization, creating the estimate of services, and having financial conversations with patients and/or guardians.
- These tasks are completed by assisting the patient, parent/guardian, or providers office with a friendly, courteous manner and high level of professionalism.
- Schedulers ensure the accuracy and integrity of patient information and test orders, while maintaining a high level of confidentiality.
- Duties may include but are not limited to:
- Able to work independently and as a member of a team.
- Understand and follow safe work practices.
- Ensure that all Amberwell procedures are followed in accordance with established policies.
- Demonstrates a knowledge of cultural diversity, the ability to provide care and service and exhibit the communication skills necessary to interact effectively with the patient/family/customer.
- Proactively serves as a patient advocate by always utilizing courteous and professional etiquette by answering the telephone promptly, reflecting a positive tone and speaking distinctly with poise, tact, and assurance.
- Coordinate with physicians, nurses, staff, patients, and other medical departments while setting up appointments, making sure prior authorization has been checked and/or received and orders are obtained prior to or immediately following the scheduling process.
- Validates the prior authorization CPT codes match the actual test that has been ordered, troubleshooting any discrepancies prior to placing the patient on the schedule.
- Responsible for ensuring the accuracy and integrity of patient information and test orders, attaching orders, while maintaining a high level of confidentiality.
- Verify medical necessity on all applicable patients scheduled by obtaining the diagnoses related to the procedure(s).
- Assign diagnosis code(s) for each diagnosis utilizing a computerized encoding system.
- Enters code(s) into medical necessity software to obtain medical necessity approval.
- Responsible for contacting the provider to validate diagnosis and/or obtain additional diagnoses if medical necessity is not met.
- Creates and processes Advanced Beneficiary Notices (ABNs) if applicable.
- Verifies insurance including copays, deductibles, and co-insurance.
- Calling for insurance benefits when needed.
- Informs patients or departments of the financial responsibilities.
- Directs patients to the Financial Counselor as indicated to discuss payment arrangements or financial assistance.
- May be asked to become a Super User for the current computer system, troubleshooting issues and performing table maintenance as needed.
- Maintains confidentiality and protects sensitive data at all times.
- Demonstrates exceptional customer service and interacts effectively with physicians, patients, visitors, staff, and the broader community.
- May be asked to perform other duties within the PFS department.
ABOUT AMBERWELL HEALTH:
- Amberwell Health is a healthcare system dedicated to improving the health and wellness of the communities we serve, providing compassionate healthcare with clinical excellence.
- Amberwell locations include several complete care facilities that provide a full spectrum of patient care services including inpatient, surgical, orthopedic, maternal, health at home, emergency care services.
- In addition, Amberwell clinic locations offer primary care and specialty care services.
- Amberwell Health supports service lines and locations across the system with a range of support services including radiology, laboratory, cardiopulmonary, rehabilitation therapy, occupational health, infusion, nutrition, pharmacy, administrative services, and many other specialty services.
AMBERWELL CULTURE:
- Amazing Amberwell employees are at the heart of a workplace focused on competencies with our cultural values.
- Excellence in healthcare is expected and our patients deserve nothing less.
- Our culture competencies range from warm greetings in the hall to providing patients with “wow” experiences in each department.
- At Amberwell, we go beyond excellence to provide the unexpected.
- At Amberwell, you will find a professional environment that values consistency, collaboration, and patient-first decision making.
- Servant leadership is both modeled and mentored, with a focus on regular appreciation.
- Amberwell employees enjoy many appreciation events and activities to help them know just how important they are to our organization, our patients, and our communities.
- To learn more about Amberwell Health, our affiliated organizations, and available career opportunities, visit careers.amberwellhealth.org.
Qualifications
JOB QUALIFICATIONS:
- Experience:
- Minimum Required Experience: Experience in health care office setting and/or customer service.
- Preferred Experience: 2+ Years
- Education:
- Minimum Required Education: Certified Medical Assistant or similar degree with experience
- Certifications:
- Preferred Certifications: Certified Medical Assistant