GENERAL SUMMARY:

Under the supervision of the Practice Manager, provides a broad level of administrative support to a physician, medical practice or clinic for patient care and administrative duties. Works independently to execute job responsibilities and tasks. Works with the physician, staff members and management to ensure a quality-based, patient-oriented flow of work. Utilizes discretion and judgement to organize priorities, complete tasks, handle confidential patient information. Performs a wide range of administrative tasks utilizing well established skills and experience to support a medical office, including surgical scheduling, prior authorizations, coding and billing as well as coordinating patient services such as appointments, testing and referrals. Performs administrative coordination of a physician(s) office to include secretarial support, data management and billing/financial support. Maintains advance knowledge and proficiency in medical office operations, insurance regulations and billing practices.

PRINCIPAL DUTIES AND RESPONSIBILTIES:

PATIENT CARE RESPONSIBILITIES

• Schedules patient office appointments; coordinating with others as appropriate. Provides information to physician as appropriate.
• Refers patients to appropriate hospital departments for registration, referral and financial services as needed.
• Obtains, provides and maintains medical records in support of patient visits, surgeries, billing and other needs.
• Maintains high level of knowledge and skill in the use of appropriate electronic systems to obtain and provide information.
• Arranges and/or provides information and visit support to patients and their families, such as distributing maps, information regarding procedures and interpreter services.
• Prepares for patient visits by placing appointment and surgery reminder calls, organizing patient files and printing forms and ensuring physician and office is prepared to provide for patient visit or surgery.
• Completes all aspects of patient checks-in in a courteous manner. This includes updating computer systems with correct and complete information, obtaining referral information and co-payments and preparing billing materials. Coordinates with clinical staff to ensure smooth patient flow.
• Monitors daily schedule and exam room utilization - communicating with clinicians and patients/visitors to set expectations and maintain efficient flow
• Completes procedures to check-out patients as they exit exam rooms, including scheduling appointments and testing
• Provides and coordinates office support to meet physician needs. This includes operating room schedules, maintaining files, dictation support, correspondence with physicians, patients and other offices or agencies
• Provides and coordinates patient appointments to include processes related to cancelled appointments and reminder notices.

ADMINISTRATIVE RESPONSIBILITIES

• Maintains physician's office to include calendar management, travel, office reception, mail processing, correspondence and reports and related responsibilities of a secretarial nature.
• Ensures timely renewal and maintains files of physician's medical license(s), DEA certificate, professional liability insurance, etc. Prepares and maintains files of hospital and managed care plan credentialing documents. Ensures office is operating efficiently by performing duties to monitor and address needs such as order supplies, maintain files and obtain literature.
• Organizes materials and information for processing of invoices and reimbursements, updating and communicating on-call schedules and for use in presentations made at national meetings. Establishes and maintains databases for practice and physician use.
• Arranges for outside visitors, medical students, etc. as requested by physician.
• Cross covers other staff members, e.g. breaks, lunches, vacations, during variations in work flow as needed.
• Participates in periodic staff meetings or other departmental meetings.
• Perform/participate in special projects as may arise from time-to-time.

SURGICAL SCHEDULING

• Arranges patient surgeries by scheduling pre-surgery appointments and testing; reschedules as needed. Obtains all required authorizations and referrals in advance of surgery. Provides information to Admitting in a timely manner.
• Utilizes Epic to schedule surgeries electronically. Updates physician calendar to block surgery schedule. Communicates any special circumstances to the physician. Distributes surgical schedules.
• Works with primary care and specialty offices to obtain patient historical data, reports, imaging studies, lab results or other information necessary for the coordination and completion of the surgery and patient care.
• Ensures patients receive pertinent patient education information about their surgeries. Confirms completion of Consent for Surgery forms. Provides patients with pre-surgical instructions in a timely manner. Addresses or refers patient and family questions regarding surgery, insurance and administrative.
• Work effectively and efficiently with insurance companies to obtain pre-authorization for any and all surgical procedures.
• Maintains files to incorporate surgical information in paper and electronic patient and office files. This includes operative notes, discharge summaries and test reports.
• May schedule post-operative appointments and testing.

BILLING

• Maintains an advanced level of knowledge regarding third party insurance, managed care and financial services and resources available to patients. Attends meetings and educational sessions to secure this knowledge base.
• Organizes and forwards patient and procedure information for billing. Answers patient and billing office questions. Resolves any discrepancies.
• Creates and maintains billing information, updating patient and hospital records. Ensures bills are processed and mailed in a timely manner. Works with patients to collect payments for all services provided.
• Investigates and resolves billing matters utilizing advanced knowledge and skill related to insurance coverage, referral management, insurance company procedures and billing process.
• Serves as a resource to administrative colleagues and physicians regarding billing procedures and collections.
• Serve as liaison to BWH billing vendors and insurance companies
• Prepare cosmetic quotes as needed and serve as a liaison with the Hospital and the Dept. of Anesthesia to collect cosmetic payments

QUALIFICATIONS:

• High school diploma required, Associates or Bachelors Degree preferred
• Minimum of 1-3 years of healthcare experience preferred.

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:

• Must maintain highest standards of professionalism, ethics, and integrity.
• Must have strong customer service, communication, and interpersonal skills in dealing with patients, providers and colleagues.
• Must be team-oriented in dealing with multiple stakeholders and communication channels and also be able to work independently.
• Must be sensitive to and supportive of patients, families, and care-providers.
• Must be resourceful in obtaining information when it is not readily available and in responding to unusual situations.
• Must have exceptional organizational skills and have ability to recognize problems, establish priorities and initiate appropriate responses.
• Exceptional computer skills (including word processing, database, email, internet, and spreadsheets) required. Knowledge of IDX and other systems at a level sufficient to perform job.
• Good command of English language, including medical and scientific terminology.
• In-depth understanding of all pertinent medical insurances, managed care and patient financial services.
• Is knowledgeable and compliant in all hospital, State and Federal regulatory requirements, including hospital policy and procedures (where applicable to the performance of the job), Joint Commission (JC), and Health Insurance Portability and Accountability Act of 1996 (HIPAA).