Job Abstract

Work Shift:

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advance technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Position Overview:

ESSENTIAL FUNCTIONS

• Collaborates with physician offices, hospital clinic or directly with patients to schedule Infusion Center patients, negotiating date and time, and avoiding resource conflicts (chairs ,rooms, nurses, equipment). Performs this task in a timely manner. Coordinates special procedure needs with appropriate CH departments and staff, as well as external resources.
• Works closely with the Infusion Center supervisor or charge nurse to schedule and maximize utilization of nursing time, productivity and resources.
• Gathers complete patient and procedure documents for each treatment to assist in patient registration and billing. These documents include the treatment prescription, patient demographics, financial information, consent (if appropriate) and a history and physical completed within 30 days.
• Is a resource for the physician offices on how to obtain pre-certification and authorizations from various insurance carriers (both in-network and out of network payers)to facilitate maximum utilization and efficiency and minimal procedure-related problems. Keeps up-to-date log sheets of procedure codes and works closely with the CH Finance Department to ensure that the coding is accurate.
• Verifies that the insurance precertification and authorization is accurate and contains the necessary codes. Confirms that all physician orders are billable and contains the necessary information (diagnostic code, CPT code or description, order date, frequency and physician signature). Verifies benefit eligibility using a variety of online systems or by calling the insurance company.
• Coordinates inter-department services and resources for patients. Assists in preparing accurate weekly volume reports for the pharmacy to be able to order all necessary drugs. Coordinates on a daily basis with the blood bank to ensure proper blood bank resources and supplies are available. Communicates with hospital transport and outside transportation resources to schedule patient transportation. Schedules diagnostic testing for patients.
• Works independently to assure prompt patient service both on the telephone and at the front desk. Oversees the registration and checkout process and the handling of medical records to assure efficient flow of patients through the office. Maintains positive working relationships with all physician offices, hospital departments and outside vendors.
• Reviews promptly with supervisor routine issues, difficulties and unusual circumstances. Handles promptly patient problems/complaints. Refers difficult situations to supervisor and Director.
• Performs all medical receptionist duties, including but not limited to, greeting patients, answering phone calls, scheduling appointments, maintaining and filing/scanning information into medical records, checking patients in and out, and completing computer and paperwork associated with these functions. Coordinates the communication of follow-up care needs to patients and physician offices as appropriate.
• Devises a system to keep track of patient authorizations for patients requiring multiple treatments. Ensures physician offices are notified prior to the expiration of authorizations to eliminate delays in patient treatment plan.
• Communications with physicians and physician offices by sending documentation of treatments, making them aware of when patients cancel appointments or when they miss their appointment.
• Works closely with the finance department on claim denials. Follows-up with insurances companies and physician offices on claim denials to obtain additional information for the appeals process on unpaid claims.
• Oversees the filing of information into medical records according to established protocol, the preparation, and the pulling and filling of charts.
• Demonstrates willingness to assist co-workers during periods of heightened patient activity.
• Works in conjunction with physician(s) and Director/Supervisor to develop and implement a practice-specific plan for the introduction and growth of the practice in the community.
• Performs additional duties upon request.

• Education: High school diploma or GED.
• Experience: Six months medical office or hospital setting experience.
• Knowledge and Skills: Excellent communication, interpersonal and organizational skills. Ability to problem solve and multi-task. Able to multi-task and manage frequent interruptions.
• Special Training: Proficient computer skills. Familiarty with medical terminology and endoscopic and/or surgical procedures and experience with variety of insurance companies preferred.

Offers are contingent upon successful completion of our onboarding process and pre-employment physical.  Capital Health will require all applicants (including contractors, travelers and consultants) to have an annual flu vaccine prior to start date, with the exception of individuals with medical and religious exemptions.