Patient Services Specialist – Call Center
UW CODE AND REPRESENTATIVE GROUP
18692 (NE S WFSE HMC)
22761 (NE H NI WFSE HMC)
BASIC FUNCTION
Work in the Outpatient Services Call Center to coordinate and facilitate patient access to Outpatient Services through independent communication between patients, all clinics and financial counseling.
DISTINGUISHING CHARACTERISTICS
Under general direction, independently coordinate all operational patient support functions in a call center for multiple outpatient services such as but not limited to: schedule patient appointments, register patients, coordinate referrals, assign payer plans, verify insurance coverage and eligibility for third party payers.
TYPICAL WORK
Triage patient telephone calls to medical and financial staff; schedule new, return, ancillary and procedure appointments consistent with patient needs and scheduling guidelines; maintain system by entering cancelled and rescheduled appointments;
Coordinate referrals with clinic staff and providers for access to specialty care, and confirm appropriate authorizations are obtained prior to service. Make sure referrals are complete and enter data online;
Provide referrals to community services and outside providers, when appropriate. Maintain familiarity with current clinic resources across the state to be able to provide patients with accurate referral information;
Register patients, collect and/or update demographic and financial information and enter it into electronic systems;
Evaluate patient financial status to verify eligibility for third party payors; assign appropriate payor plans; maintain confidentiality of patient information;
Complete and enter Medicare as Secondary Payer online form for all accounts with Medicare and initiate the Advanced Beneficiary Notice when appropriate;
Advise patients regarding charity care screening process and coordinate patient funding needs with Financial Service counselors; ensure applications for coverage are initiated prior to appointment and review final coverage status of patient prior to day of service;
Provide information of general and specific nature about the medical center to patients and visitors, including directions, services, facilities, and parking;
Assist in orienting new attending physicians, residents, students and staff to the clinic office procedures;
Communicate various types of information to patients, referral agencies, departments, physicians and the community such as financial arrangements for special programs and experimental protocols, hospital charge estimates, insurance coverage and billing procedures;
Initiate and maintain the organization of the patient chart; collect/distribute patient records, referrals, special forms, and charge documents to facilitate patient check-in and check-out;
Update current patient account information to assist in resolving denied charges due to registration issues for all outpatient clinical services, regardless of where the registration was performed;
Schedule and/or submit request for interpreters for patients;
Arrange for patient transportation to outside facilities; arrange patient transport within facility;
Perform general clerical duties such as distributing messages via paging, in basket or email, processing mail, assembling and sending information to patients;
Participate in preparation and maintenance of policies and procedures for area of responsibility;
May coordinate death procedures, including disposition; complete appropriate documentation;
Perform the work of a Patient Services Representative;
Perform related duties as required.
MINIMUM QUALIFICATIONS
High school graduation or equivalent AND four years of general office experience or two years of call center and/or medical clinic experience OR equivalent education/experience.
CLASSIFICATION HISTORY
08/16/2006: New Class