Physician Support Representative III

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Location (Full Address):

601 Elmwood Ave, Rochester, New York, United States of America, 14642

Opening:

Worker Subtype:

Regular

Time Type:

Full time

Scheduled Weekly Hours:

40

Department:

910131 Thoracic Surgery

Work Shift:

UR - Day (United States of America)

Range:

UR URCD 204 H

Compensation Range:

$19.47 - $25.77

Responsibilities:

GENERAL PURPOSE:
Performs complex secretarial and administrative duties, in a fast-paced environment with minimal direction and considerable latitude for independent judgment, in support of the clinical, educational, and academic programs for the Faculty of Thoracic and Foregut Surgery. Responsibilities include time and calendar management, telephone triaging and management, prior authorizations and information/data support.

ESSENTIAL FUNCTIONS

Patient Scheduling and Coordination of Care 40%

• Receives incoming patient telephone calls for surgeon(s) and nurse practitioner(s), managing and/or resolving various scheduling/coordination issues and answering questions as needed. Coordinate scheduling of patients at multiple practice sites; coordinates referrals for consults. Obtains patient medical records to facilitate patient care. Documents telephone calls into ERecord. Triages telephone calls from patients and referring physicians to surgeons, residents and nurse practitioners.
• Schedules appointments, tests, and surgeries, coordinating appointments, tests and consults in preparation for surgery or further clinical work-up. Acquires prior authorizations for appointments,
• X-rays and Scans, which requires detailed filling out of specific request forms with patient medical information. Also includes getting prior authorizations for surgeries which may require speaking with insurance companies’, nurses and giving specific health information from patients records to get authorization. Interacts effectively in carrying out these responsibilities, presenting a positive image for the Division of Thoracic and Foregut Surgery. Works regularly with URMC patient registration and clinical information systems.

Prior Auth Duties 35%

• Performs complex patient prior authorization duties, in a fast-paced environment with minimal direction and considerable latitude for independent judgment in the Division of Thoracic /Foregut Surgery. Serves as the patient prior authorization specialist, with oversight of data and compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff, identifying barriers to appointment compliance, insurance company barriers and tracking all assistance provided. Adheres to approved protocols for working referrals and prior authorizations. Makes decisions that are guided by protocols and practices requiring some interpretation; maintains an expert level understanding of the department/division.
• Prior authorization functionality required for testing and services ordered by referred to specialist includes, preparing and providing multiple, complex details to insurance or worker’s compensation carrier to obtain prior authorizations for both standard and complex requests such as imaging outside of UR imaging, non-invasive procedures, Motility testing, surgeries, new patient and follow-up clinic visits etc., c ommunicating medical information to the insurance carrier, and coordinating peer-to-peer reviews for denied services. Manages the Missing referral queue and ensures all authorizations are obtained and documented.
• Applies knowledge and protocols to varying degrees based on how complexities of the situation deviate from the norm. Resolves obstacles presented by the insurance company by applying knowledge and experience of previous authorization requests, denials and approvals. On behalf of the provider and the University, perseveres with the process to ensure as many applications are approved as possible without provider intervention.

Time and Calendar Management (10%)

• Functions one of the points of contact for the surgeons and APP’s of the Thoracic and Foregut Division of Surgery. Effectively balances competing demands of surgeon time by managing calendar, including all clinical activity, administrative meetings, research, education and academic commitments.

Other Office Management 10%

• Coordinates work with nurse practitioner(s). Manages all incoming mail for surgeon(s) and nurse practitioner(s) assuring that all correspondence receives timely attention and is followed up appropriately. Manages routing supplies and ensures expenses, including physician dues, fees and related practice expenses, are reimbursed appropriately. Coordinates transfer of patient studies to and from other hospitals and physician offices. Assists with department hiring processes by training incoming new secretaries or temporary secretaries when requested. Scans patient information into OnBase. Functional knowledge of various office equipment. Provides coverage for absences within the division, off-site practice location, and within the department when requested.

Other duties as assigned.

QUALIFICATIONS

• High School Diploma required.
• Associates degree in Medical, Secretarial, billing or related field preferred.
• 2 years of relevant experience required; or an equivalent combination of education and experience required.
• Medical Terminology, experiences with surgical/appointment scheduling software, and electronic medical records, preferred.
• Excellent interpersonal skills, customer service skills and organizational skills preferred.
• Strong attention to detail and communication skills, including written communication preferred.
• Working knowledge of word processing and spreadsheet applications preferred.
• Experience in medical office setting preferred. eRecord, Cadence and medical terminology preferred.

EOE Minorities / Females / Protected Veterans / Disabled:

The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.