Care Command Specialist-1

Care Command Specialists provide the clerical support for the Care Command Center including call center job duties, facilitating requests for admission and the logistical steps for access to Phoebe Health System. The Care Command Specialist is responsible for the inpatient, medical observation, surgical and procedural entry registration functions including creating the patient account, recording the insurance information, updating the patient account as per regulatory guidelines. Provides the registration duties related to converting patients to active status, conversion from OP to IP, production of labels and armbands. The Specialist is also responsible for the EVS coordination for bed cleaning process, the Central and EMS Transport coordination, Teletracking updates and functions. The clerical support for the Care Command Center includes but is not limited to answering telephone calls, entering information into critical databases, phone calls to key stakeholders to complete actions, managing critical patient flow transactions.

• High School Diploma required
• Associate Degree in a related field preferred

Work Experience: 1 year Health related field (hospital or Physician's office) preferred

ORGANIZATIONAL SKILLS - PATIENT ACCESS:

• Must be proficient in time management and identifying priorities.
• Monitors status and utilizes criteria to screen all scheduled appointments in various departments to address all uninsured, high deductible and ineligible patients prior to their date of service.
• Monitors status of point of service collections to facilitate patient financial clearance.
• Express options for patients that include cost estimates, payments plans, discounts and supplemental financial assistance
• Obtain financial data during initial intake of screening application at time of scheduling.
• Completes a predetermination of pending services, or a financial workup in association with patient needing indigent and charity assistance. This could include, but not limited to: verifying insurance, ensuring that precertification(s) has been obtained, gathering various financial information to be used to confirm indigent or charity assistance
• Verifies that prior authorizations and eligibility have been obtained if applicable. If neither task (prior authorization or eligibility) has been completed, then proper action is to be taken such as (not inclusive), contacting Patient Access personnel, notifying immediate management, validating with the insurance carrier(s); running eligibility via online tools, or contacting the insurance carrier.
• Screens and take applications for financial assistance and assists in obtaining needed information for review from the patient or the guarantor
• Coordinates with various government agencies, internal departments, or vendors to gain assistance with Disability, Medicaid, Cancer State Aide, COBRA, ACA, etc.
• Provides support to the patient or guarantor by helping them understand and navigate through their financial responsibility relating to physician and hospital billing, insurance payments and denials, during the course of their treatment
• Secures information relative to patient's financial status for collection purposes, estimates patient liability, performs a financial assessment and arranges for payment in full or a payment plan for patients without adequate third party coverage
• Assist with administering various State and Federal programs such as the Maternal Grant, Condition Code 44, etc., audit inpatient and observation accounts for accuracy and admission coverage

ADMINISTRATIVE RESPONSIBILITIES:

• Provides administrative duties to support the effective operation of the office and department.
• To work with send out department for all send out tests.
• Uses meditech, pathology module, for printing of pathology reports, accessing surgical specimens and consultation, both in house and outside, looking up confidential patient information in the EMR. Access to the old systems such as copath to access old pathology cases.
• Scan reports in patient files.
• To communicate with outside offices pertaining to pathology reports, slides blocks, etc.
• To communicate and work in conjunction with hematology oncology pertaining to all surgical cases regarding all tests that the oncologists order for their patients.
• To regularly go to the morgue to re-file or pull old blocks.
• The pathologists have weekly tumor, chest and breast conferences and the cases must all be pulled including all pathology reports and all previous cases pertaining to each patient.
• To communicate and work together with the pathologist's billing company.
• To submit invoices to accounts payable and organize mail

PROFICIENT CLERICAL SKILLS:

• Acts as a clerical resource agent, assures proficient operation of department clerical activities.
• Ensures accurate departmental database documentation. Reviews/Interprets patient chart material (orders, prescriptions, referrals) for accurate database incorporation. Complete ordered referrals.
• Ensures monitoring of phone message system, including retrieval, log documentation/patient report preparation to facilitate Physician/RN review/resolution. Review phone message logs to assure resolution/facilitate patient communication, ordered referrals and appointment changes. Incorporates resolved messages to department data base.
• Manages/Assures efficient utilization of telephone communication. Handles large volumes of incoming phone calls. Elicits appropriate support as required.
• Manages Fax server. Reviews and labels all incoming fax documentation, prints diagnostics reports for Physician/RN review.
• Ensures accurate charge entry and reconciliation.
• Ensures chart maintenance including chart assembly, storage, distribution, replacement and HIPAA compliant file/medical information disposal.
• Performs receptionist duties independently with exceptional customer service (sign-in, chart direction)

COMMUNICATION:

• Demonstrate the ability to communicate in a professional manner.
• Demonstrate excellent customer service skills.
• Communicate effectively with patients, staff and physicians.
• Hold staff members accountable for communicating professionally.
• Act as a resource person within the department regarding communication skills.

CUSTOMER SUPPORT:

• Provides prompt assistance to customers, ensuring needs are met
• Answers all incoming calls timely to ensure prompt assistance and great customer service to callers.
• Greets customers with a smile ensuring customer experiences an open and warm welcome.
• Assists callers by using overhead paging systems as needed, utilizing established protocol.
• Handles on-call procedures for staff and physicians as identified.
• Maintains directory and files on active and discharged patients, their location, patient status and other pertinent information according to established procedure.

CUSTOMER CENTERED SERVICE EXCELLENCE:

• Demonstrates commitment to the highest standards of customer satisfaction by displaying courtesy and sensitivity and responding promptly to customer needs.
• Strong performance includes mastery of the following skills and tasks and related behaviors:
• Manages difficult or emotional customer situations.
• Meets commitments, and recognizes and acts on service opportunities.
• Receives and applies feedback to improve quality and service.

Additional Duties

• Adheres to the hospital and departmental attendance and punctuality guidelines.
• Performs all job responsibilities in alignment with the core values, mission and vision of the organization.
• Performs other duties as required and completes all job functions as per departmental policies and procedures.
• Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs).
• Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
• Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs.

For non-clinical areas, has attended training and demonstrates usage of age- specific customer service skills.

Wears protective clothing and equipment as appropriate.