Scheduler/Registar/Float - Central Scheduling
The Scheduler is responsible for ensuring scheduling of all diagnostic imaging procedures, surgeries, CIVIC, sleep studies, and other outpatient procedures utilizing the current scheduling software. Employees within this department must be familiar with ICD 10 codes in order to check for medical necessity. Performs the scheduling of outpatient services and functions in a manner that promotes positive relationships with patients, physicians, hospital departments, and visitors. Exhibits proficiency in all aspects of scheduling and pre-certification. Pre-registration and pre-certify outpatients by obtaining necessary, accurate financial and demographic information. Consistently exhibits excellence in patient/customer service.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Scheduler Specific Expectations:
1. Promotes positive interactions within all departments and with all staff members.
2. Maintains a positive image / attitude at all times and in all situations.
3. Supports and promotes upper management direction and decisions.
4. Ensures that the Standards of Behavior at SMMC are upheld at all times by themselves and those around them.
5. Staffs department as workload levels require.
6. Provides education and training to all staff members.
7. Has authority to delegate assignments.
8. Performs all other job duties as assigned.
Demonstrates competency in the following areas:
General Clerk Duties/Registar
1. Obtains and verifies demographic, emergency notifications, employment and insurance information every time the patient has services.
2. Makes copies of drivers' license, social security card and insurance cards as needed.
3. Enters required information into the Meditech and Exitcare systems as necessary.
4. Correctly enters all mneumonics and codes to ensure accurate billing.
5. Completes Conditions of Admission form correctly.
6. Explains the necessary admission forms to the patient and obtains the necessary signatures.
7. Prepares paperwork, labels, door tag and ID bracelets as to patient type.
8. Collects pre-payments and deductibles as indicated.
9. Writes receipts for cash/check payments and indicates patient name and account number. Includes patient's name and account number on credit card receipts.
10. Answers and handles phone calls in a courteous, professional manner.
11. Enters all required information into the host system, including but not limited to patient demographic and authorization numbers.
12. Correctly enters all information and codes to ensure accurate billing as provided by the ordering physician's office.
13. Verifies insurance information via Passport, TMHP or the payer's website.
14. Interacts professionally with physicians, patient/family and co-workers. Treating them with courtesy, dignity and respect.
15. Enters comments in account inquiry for future reference including but not limited to telephone conversation informing the patient of their money due at the time of service, authorization numbers and insurance verification information obtained from the patient's insurance carrier.
16. Answers and handles phones call in a courteous and professional manner.
17. Maintains a clean, safe and sufficiently stocked work area.
18. Employee is cross trained in all areas of central scheduling to assist others as necessary including but not limited to Leading Reach, scheduling procedure/surgeries, verification of insurance benefits and calling patients to inform them of estimated patient financial responsibility at the time of services.
19. Calls patients at least 48 hours in advance to inform them of estimated patient financial responsibility at the time of service and collects down payment over the phone when possible. If patient cannot pay at the time of service the scheduler will discuss the case with the physician to determine if the services can be delayed until the patient can pay their portion until an acceptable payment arrangement can be made with the patient/guarantor.
1. Reviews Leading Reach to ensure all physician orders sent to the facility via this program are worked in a timely and effective manner and a backlog of unscheduled appointments does not exist.
2. Ensures Leading Reach orders are printed and put in the daily folder for the registration staff the day prior to services being rendered.
3. Reviews Leading Reach to ensure all tests that have been performed are marked as completed in the Leading Reach program.
4. Works with physician offices after three voice mails have been made attempting to schedule the patient for their service but scheduler has not been successful in reaching the patient.
5. Ensures communication is effective and timely between the scheduler and physician office as documented in Leading Reach.
1. Scheduler must verify patient benefits and that authorization are in place for those services that require authorization.
2. Scheduler calculates patient estimated patient financial responsibility at the time of service and information the patient of their financial responsibility at the time the Scheduler contacts the patient to inform them of their appointment for their services. Scheduler will also write the amount of money due from the patient on the face sheet that is sent to registration.
3. Scheduler will pre-register all scheduled appointments to the greatest extent possible and provides this information to the registration team at the end of each day along with any appropriate paperwork such as face sheets, labels as well as documenting this information in the account inquiry notes field. Exceptions to pre-registering scheduled services would include situations where the Scheduler does not have or cannot obtain sufficient insurance information from the patient or physician office.
Outpatient Specific Duties
1. Scheduler pre-admits patients for future services. Outpatient services include but are not limited to radiology, CIVIC, same day surgery, sleep studies, IV hydration and blood transfusions.
2. Validates Scheduler prepares all necessary paperwork for ambulatory care services, laboratory services, imaging services and respiratory services at least 48 hours in advance so other department team members can perform their job duties prior to the patient's arrival for services.
3. Validates Scheduler works closely with all outpatient departments to provide quality care to all patients.
Per-Certification and Insurance Verification for Inpatient Services
1. Validates Scheduler verifies insurance benefits on all patient admitted to the hospital.
2. Validates Scheduler initiates pre-certification on all patients admitted to the hospital.
3. Ensures Scheduler notified case management of all admissions via email.
4. Ensures Scheduler calculates patient's estimated patient financial responsibility for inpatient services and visits the patient while the patient is in house to communicate this information. If financial arrangements are necessary the Scheduler will discuss with the patient and scheduling supervisor to achieve a satisfactory financial agreement with the patient and inform the patient of the organizations financial assistance policy when appropriate.
5. Validates that Scheduler works closely and effectively with case management and social services.
6. Validates the Scheduler monitors Conditions of Admissions for appropriate signature and obtains signatures as needed.
Ensures scheduled appointments are scheduled in a manner that maximizes staff productivity of not only the scheduling staff but also the ancillary departments that are to perform these tests.
OR Scheduling and Pre-Operative Services
1. Schedules all surgeries as called into, uploaded in Leading Reach or faxed the department by physicians or physician's offices.
2. Makes scheduling decisions reflecting knowledge of surgeon preferences and length of surgical procedures, using good judgement.
3. Organizes and prepares the Surgery Schedule and updates all appropriate departments as appropriate but not less than on a daily basis.
4. Reviews surgery schedule for appropriate registration/admission times and notifies the patient of any changes 48 hours in advance.
5. Notifies Department director and anesthesia provider of any changes in surgery line-up. If schedule has already been distributed, notifies appropriate departments.
6. Provides registration personnel with physician orders in a timely manner.
7. Acquires patient's medical history during interview process.
8. Instructs patient on procedural preparations, i.e. bowel prep, etc.
9. Participates in PI by assisting with data collection, utilizing the standards of care as a resource for nursing practice.
10. Schedules and performs pre-operative services as appropriate and/or directs patients to the appropriate area to obtain these services.
Education and/or Experience:
High School Diploma or GED.
Experience equivalent to 6 months in Patient registration.
Position Type : Full Time
Shift : Day
St. Mark's Medical Center
One St. Mark's Place
La Grange, TX 78945