SCHEDULER LEAD

Description

The Central Team Leader role requires a detailed knowledge of all aspects of acute preregistration, scheduling, electronically verifying insurance eligibility and accurately identifying patient financial responsibility. 

• Team Leader will focus on timely and efficient customer service.
• Primary task is registering patients with correct insurance and personal information – ensuring physician prescriptions to ensure they are current and have not expired; current copies of cards; signature of patients; send copies of registration to medical records, patient access, and physician office; patient accounts that require pre-certification insurance verification and authorization numbers must be obtained timely; Calculate and collect patient liable amounts.
• Provide patient receipts for payment.
• Other duties include: general clerical duties such as answering phones or ordering departmental supplies and keep work area clean
• Computer skills required.
• Must have above average communication skills.
• Must have ability to interactions with employees and other staff must promote harmonious and cooperative working environment
  
  

TASKS:

• Monitors call center queue to ensure all metrics meet or exceed industry benchmarks. 
• Assists manager in monitoring call handling software and real time reports to ensure calls are being answered within SLA guidelines with the ability to make quick, sound business decisions based on the inbound call volume and/or staffing changes. 
• Accurately schedules appointments using scheduling protocols and insurance requirements via current HIS (Health Information System). Collects and documents all required demographic and financial information.
• Completes scheduling of appointment, pre-registration, insurance verification and authorization requirements with collection of out-of-pocket payments as applicable based on Bronze Standard.
• Analyzes patient insurance(s), identifies the correct insurance plan, selects appropriately from HIS insurance and plan selections and documents correct insurance order.  Applies recurring visit processing according to protocol. 
• Screens outpatient visits for medical necessity and issues Advanced Beneficiary Notice as appropriate for Medicare primary outpatients. Provides cost estimates for patients and/or family members.  Collects and documents Medicare Questionnaire and obtains information from the patient if third party payers need to be billed (i.e. worker's compensation, motor vehicle accidents and any other applicable payer)
• Provides Financial Advocacy through screening of self-pay patients & out of network patients using approved technology.  Provides information for follow up and referral to the RHM Medicaid Vendor and/or Benefit Advocate as appropriate. Initiates payment plans and obtains payment.  Informs and explains all applicable government and private funding programs and other cash payment plans or discounts to the patient and/or family.  Incorporates point of service (POS) collection processes into daily functions.  
• Review Admit Reports for Insurance Accuracy, daily
• Holiday back-up for FC, to ensure VA is notified of admissions within 72 hours.
• Answer telephones, and direct calls to appropriate staff.
• Perform various clerical and administrative functions, as required.
  
  

EQUIPMENT LISTING:

• Computer
• Ten Key Calculator
• Copy Machine
• Telephone System
• Typewriter
• Fax Machine
  
  

DEGREE OF SUPERVISION REQUIRED:

Minimal - Involves guidance and direction by PAS Supervisor. This position requires working closely with registration staff.

PHYSICAL DEMANDS:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical Demands: While performing the duties of this job, the employee is required to stand; walk; sit; use hands to finger, handle, or feel objects; equipment, or controls; reach with hands and arms; balance, stoop, kneel, or crouch, talk or hear. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus. May be required to assist patients with personal items weighing up to 30 pounds

Qualifications

LICENSURE/CERTIFICATION/REGISTRATION:

None

EDUCATION:

High School diploma.

EXPERIENCE:

Minimum 1-year Health Care Related Experience Required.

SKILLS:

Service Orientation — Actively looking for ways to help people.

Computer Skills – basis computer applications

Active Listening — Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.

Reading Comprehension — Understanding written sentences and paragraphs in work related documents.

Speaking — Talking to others to convey information effectively

Coordination — Adjusting actions in relation to others' actions.

Active Learning — Understanding the implications of new information for both current and future problem-solving

Time Management — Managing one's own time and the time of others.

Writing — Communicating effectively in writing as appropriate for the needs patients, doctors, or family

ABILITIES:

Oral Comprehension — The ability to listen to and understand information and ideas presented through spoken words and sentences.

Oral Expression — The ability to communicate information and ideas in speaking so others will understand.

Speech Clarity — The ability to speak clearly so others can understand you.

Speech Recognition — The ability to identify and understand the speech of another person.

Written Comprehension — The ability to read and understand information and ideas presented in writing.

Problem Sensitivity — The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.