Outpatient Services Rep LEP

Summary Under general supervision and according to established policies and procedures, schedules outpatient clinic appointments; receives interviews and registers patients and prepares related paper and electronic records. As needed provides customer assistance to patients with limited‑English proficiency (LEP) through use of second language skills (non‑English) to explain basic information regarding clinic policies and procedures billing procedures and to assist in completing registration and related forms. Recognizes need for more specialized interpretation required of patient and family and requests same through hospital internal and external interpreter services. Performs duties associated with preparation of patient records; registration and pre‑registration activities; problem resolution; appointment scheduling; and co‑payment preparation and collection. In addition ancillary duties performed provide tracking and status of follow‑up care as it pertains to specific diagnostic coding billing/payment resolution and generation of system reports which reflect scheduling activities. Responsibilities Schedules outpatient clinic appointments for patients through the use of the hospital's electronic scheduling system. This includes establishing the appointment type, specific provider, clinic, and appointment time. Schedules follow‑up appointment using the online scheduling system. Mails informational material to new patients in advance of scheduled appointments. As necessary contacts agencies outside the Hospital to obtain pertinent patient information and to coordinate clinic/treatment programs. Contacts third‑party payors to obtain required pre‑authorizations in accordance with established policies. May schedule appointments for patients who need lab work, diagnostic imaging or referral to other medical providers. Refers technical/clinical inquiries to appropriate personnel. Utilizes the online billing system to enter diagnosis/service codes from encounter sheets. This includes accurately entering the appropriate code in the hospital's billing system. Obtains and organizes medical records for use by physicians and nurses. Ensures patient's file is complete prior to treatment/clinic visit including appropriate records lab test results and x‑rays. Evaluates file prior to schedule visit and follows up with other Hospital departments to obtain missing data. Acts as an outpatient center receptionist. Makes telephone calls to patients as appointment reminders. Answers incoming calls. Returns phone calls to patients' physician offices and other medical providers such as laboratory and radiology facilities. Greets arriving patients and verifies pertinent information and physician using the online billing system. Orients patients to the specific outpatient center as a hospital‑based service. Interacts effectively with patients and their family members to provide mature quality customer service. Uses non‑English language skills and oral communications to provide high level of culturally appropriate customer service to those patients and families who have limited English proficiency explaining clinic procedures, obtaining demographic and financial information in order to complete registration and related forms and records. Is familiar with the role of the interpreter in providing more specialized medical‑related translation and interpretation skills calling upon those services as appropriate in order to address more complex needs of the patient and family members. Contacts the hospital's interpreter services and/or the automated language assistance line to request additional support as necessary. Completes pre‑registration and registration process using the online billing system. Verifies demographic data, insurance authorization information, co‑paids and physician. Collects co‑payments and provides patients with receipts. Produces registration cards using the online system and card embosser. Photocopies front and back of insurance card. Confirms patient eligibility with insurance carriers and obtains visit authorizations. Ensures all coding and billing duties are performed in accordance with department policies and procedures. Using the online billing system enters diagnosis codes/service codes as indicated on encounter sheets. Verifies the appropriateness of the diagnostic code prior to entering in the billing system recognizing errors or omissions and follows up with appropriate clinic personnel to resolve. Interacts with patients and representatives in patient financial services in order to resolve billing issues, including denials. Appropriately refers patients to patient advocate for financial counseling. Prepares and maintains related reports using both the online scheduling and billing systems. May respond to telephone calls/inquiries by rotating into a centralized setting (i.e., a call room). Provides all duties in accordance with the hospital's mission, the defined role of ambulatory care and defined administrative/clerical rules, procedures and policies. Basic Knowledge High School Diploma or equivalent. Effective oral and written communication skills including specific non‑English fluency as spoken by clinic clientele and/or population serviced. Experience Six to twelve months related clerical experience preferably in a high‑volume clinic setting with demonstrated familiarity with online computer data entry/access procedures, medical terminology and clinic billing processes. Experience should demonstrate high level of customer service, cultural sensitivity and effective oral and written communications skills in English and a specified second language. Work Environment and Physical Requirements Walking, sitting, standing throughout the day in clinic setting. Supervisory Responsibility None. #J-18808-Ljbffr Lifespan