Appointment Rules Verification Specialist

Description

 

JOB DESCRIPTION: Appointment Rules Verification Specialist 

 

COMPANY WEBSITE: https://freedomhealthcare.biz/

 

COMPANY PHONE NUMBER: (667) 770-6320

 

HUMAN RESOURCES PHONE NUMBER: (410) 372 4513

 

POSITION TITLE: Appointment Rules Verification Specialist

 

ALTERNATE TITLE(S): Appointment Rules Verification Specialist

 

COMPANY: Freedom Health Systems, Inc.

 

DIVISION: Operations Division

 

DEPARTMENT: Scheduling Department

 

UNIT: n/a

 

CLASSIFICATION: W8BEN

 

COMPENSATION RANGE: $5.00 per hour

 

WORK SCHEDULE: 40 hours per week in virtual HR suite at 3310 Eastern Avenue, Baltimore, MD 21224 office from the hours of Monday to Friday from 8:00 AM EST to 5:00 PM EST

 

ACCOUNTABLE TO: Scheduling Department Manager

 

ACCOUNTABLE FOR: CODC, ECM, CRNP, CRNP-F, DSP, CPRS, HHCM

 

ANTICIPATED TRAVEL: 0% of the time.

 

SUMMARY OF POSITION RESPONSIBILITIES: The Appointment Rules Verification Specialist is responsible for ensuring the accuracy and compliance of scheduled appointments to prevent billing issues and conflicts. This role involves meticulous oversight of appointment codes, schedule adjustments, and the maintenance of critical scheduling documents. The specialist will coordinate and verify that appointments do not overlap or conflict with other provider appointments, thereby supporting the seamless delivery of services to clients.

 

SCHEDULED DUTIES AND RESPONSIBILITIES:

 

1. Review scheduled appointments daily and weekly to ensure there are no conflicts with other providers’ appointments.

2. Adjust and substitute conflicting appointments with valid alternative codes, ensuring providers can continue delivering services without interruptions.

3. Plan and schedule necessary bloodwork and urine screening appointments for clients, ensuring all relevant appointments are accounted for and non-conflicting.

4. Export and update the Active Client List in the designated spreadsheet daily, ensuring all entries are current and accurate.

5. Update the housing roster by comparing Buildium vs. ICANotes Active Clients, specifically updating the "CAT A | CAT B" tab on a weekly basis.

6. Generate and distribute weekly and monthly reports related to appointment code conflicts, providing detailed analysis and actionable insights to management.

7. Conduct daily and weekly rules verification to ensure all appointments adhere to established guidelines, reducing the risk of billing concerns and service disruptions.

8. Update and monitor the DSP and CPRS sheets, comparing the FHS sheet versus the 1. Position Seat Sheet to ensure accurate client assignments.

9. Maintain and update the DSP/CPRS assignment sheet, ensuring new clients are added and discharged clients are removed promptly.

10. Monitor and update the DSP/CPRS calendar, ensuring it accurately reflects current assignments and service needs.

11. Update the PRP calendar for group appointments on a weekly basis, ensuring all scheduled sessions are correctly documented.

12. Review and update PRP Monthly Progress for individual sessions during the 4th week of each month, ensuring accurate tracking of client progress.

13. Perform other duties as assigned by the Scheduling Department Manager to support the overall efficiency and compliance of the scheduling department.

 

UNSCHEDULED DUTIES AND RESPONSIBILITIES:

 

1. Participate in external and internal audits/surveys (CARF/CSA/OHCQ) as directed by the supervisor.

2. Participates in quality assurance and performance improvement plans by completing periodic audits or other activities to ensure regulatory compliance and/or improve service delivery.

3. Assist the supervisor, HR, or management with any work-related tasks as requested.

4. Responsible for following regulations of COMAR, CARF, any other regulatory body, and company policies/procedures related to your scope of work.

5. Co-facilitating orientation of all new hires if requested.

6. Support the maintenance of a safe environment by participating in training and drills as requested.

7. Advise the supervisor on the development and implementation of protocols to better enhance the efficiency of day-to-day operations effecting change when approvals are made.

8. Troubleshoot and abate any issues that could adversely affect the day-to-day operations.

9. Report to the Supervisor daily and as requested. Report deviation of operational standards to CEO daily.

10. Check emails and company group texts at least every 30 minutes while on duty; respond accordingly.

 

PHYSICAL DEMANDS: Regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard.

WORKING CONDITIONS: Remote work environment

Qualifications

COMPETENCIES AND SKILLS:

 

Strong understanding of appointment scheduling rules and guidelines.

Excellent organizational and problem-solving abilities.

Proficiency in scheduling software and tools.

Effective communication and interpersonal skills.

Attention to detail and ability to maintain confidentiality.

 

Preferred Attributes:

Experience with electronic health records (EHR) systems and scheduling software.

Knowledge of industry-specific appointment scheduling practices and regulations.

Familiarity with process improvement methodologies.

 

LEVEL OF EDUCATION / TRAINING / QUALIFICATIONS:

 

Education: Bachelor’s degree in business administration, Healthcare Administration, or a related field. Relevant certifications or additional training in scheduling or operations management are a plus.

 

Experience: Minimum of 2 years of experience in scheduling, operations, or a similar role, with experience in rule verification or policy enforcement preferred.

Salary : $4 - $5