Under the direction of the manager or designee, supports the functions of the Scheduling Office by facilitating and producing the ORMIS Daily OR Schedule and its supporting documents in a timely and accurate fashion.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
1. Locates order on the Depot and accurately schedules procedures in the proper Epic system, such as OpTime, Cupid, or Radiant.
a. Scrubs case order for accuracy and completeness. Ensures diagnoses and procedure match. Reviews all OpTime case data for errors and ommissions.
b. Reconciles laterality issues, such as missing laterality and mismatches on laterality between diagnosis and procedure.
c. Escalates case orders and laterality issues back to ordering provider for any needed corrections.
d. Orders special grafts and tissues as needed through coordination with vendors and the clinical team.
e. Places and/or moves case on scheduler grid (called the Snapboard) to correspond with time/room requirements.
f. Provides case duration estimates. This involves comparing historical averages with surgeon estimates and taking into account room turnover time and other factors.
g. Adds case information to additional databases, such as Jamitron, per departmental guidelines.
h. Ensures optimization of providers' schedules by promptly moving patients up if there are cancellations.
i. Reschedules surgical cases/procedures as needed and informs necessary parties about changes to schedule.
j. Schedules complex joint surgical cases as needed.
k. Recommends the necessary/appropriate doctor preference cards and supply picklists for each case.
2. Schedules appointments to the correct provider, including all appropriate information, and coordinates appointments on the same day when available.
a. Uses advanced knowledge of Access tools and workflows to serve as an integral part of the care coordination team.
b. Responsible for utilizing decision based tools to facilitate securing the right appointment with the right medical provider or team.
c. Schedules pre-op and post-op appointments within correct time frames and coordinates/confirms with patient.
d. Maintains competence in use of scheduling and web applications.
e. Appointments are made appropriately and correctly, including right patient, to right provider, right amount of time, right type of visit, right information, and using the right process.
f. Facilitates healthcare team discussions about complex patient scheduling needs. Responsible for scheduling multispecialty patient appointments efficiently. Takes ownership for resolving scheduling conflicts and communicates with management team and care providers to resolve scheduling issues.
g. Requests and/or sends records to Health Information Services in a timely manner.
h. Obtains required insurance information and loads or verifies for each appointment scheduled.
i. Accurately completes required tasks and fields in pre-registration.
j. Investigates referring provider or patient concerns when complaints are brought forward.
3. Demonstrates the skills of effective communication, decision-making, and organization to ensure efficient job performance and job success.
a. Educates patients on pre-surgery/procedure requirements and what to expect on the day of the surgery/procedure based on information provided by the clinical care team to increase understanding and alleviate anxiety. Appropriately escalates clinical questions. Refers patients to the Pre-Evaluation Testing Center (PETC) as needed.
b. Communicates vital changes to the surgical/procedural schedule, such as Add-on Same Day Surgeries, using appropriate communication pathways to all impacted parties including, but not limited to, the OR Scheduling Team.
c. Manages the provider calendar by capturing and communicating out-of-office dates and releasing OR time for use by another provider.
d. Daily work is accomplished with minimal direct supervision.
e. Work priorities are set in order to accomplish tasks/goals.
f. Confidential matters are handled appropriately.
g. Familiarity with current ICD-10 and CPT codes is demonstrated.
h. Communication with department billing staff is accomplished in a timely manner to ensure accurate pre-certification/authorization information is aligned with accurate billing of services.
i. Comprehension of insurance data, benefits, in/out-of-network issues, notification requirements, pre-determination services, and medical diagnosis is consistently demonstrated in order to ensure that all pre- authorizations are completed prior to the date of service.
j. Sound judgment is consistently demonstrated about when to involve providers or other healthcare professionals in the pre-authorization or denial process.
4. Educates patients, parents, guardians, and/or appropriate designee on managed care process and communicates authorizations, if needed. Reviews potential financial obligations when appropriate.
a. Communicates what payments are due at the time of service and explains the risks of "going out of network" for services.
b. Informs patients about the authorization status as necessary.
c. Prepares patient financial liability estimates and takes payment as needed.
d. Demonstrates skill in the use of telephone technology.
5. Provides high-level customer service to referring providers and referred patients.
a. Establishes initial contact with referring providers and referred patients by telephone.
b. Provides patients with an overview of the procedure process. Manages more complex patient calls, using appropriate customer service skills.
c. Ensures patients complete pre-op requirements prior to date of surgery.
d. Establishes positive relationships with referring providers, referred patients, and referring provider office staff.
6. Assists with operational patient flow as applicable; performs problem-solving.
a. Advocates for patients by helping them navigate through the system.
b. Directs and assists patients, families, and staff in accessing appropriate resources.
c. Develops tools to assess patient referral processes with respect to efficiency and customer service.
d. Performs all other related tasks that would facilitate the flow of patients through the process or that would enhance the quality of service to patients.
e. Implements practice/procedural changes accurately and in a timely manner.
7. Maintains current working knowledge; adheres to Health System and departmental policies and procedures.
a. Provides cross-coverage for registration and scheduling, as necessary.
b. Verifies patient demographic and additional identifying information appropriately.
c. Required tasks and database information, not completed during intake, are accurately completed prior to forwarding case.
d. Exhibits a thorough working knowledge of scheduling and insurance practices.
8. Demonstrates an ability to work as a part of a collaborative team with considerable autonomy and with attention to detail.
a. Uses the Department Appointments Report (DAR) to ensure clinic operations run efficiently.
b. Verifies providers' orders are present, accurate, and complete by applying knowledge of medical terminology, the International Classification of Diseases (ICD-CM) to classify patient sickness and disease, and the Current Procedural Terminology (CPT) for describing medical, surgical, and diagnostic services.
9. Contributes to and assists with the professional development of others.
a. The education and development of others is fostered through precepting new employees and role-modeling behavior.
b. Maintains a positive environment conducive to education of coworkers through precepting, mentoring, teaching, orienting, role modeling, and team participation.
c. Annual mandatory training activities are completed within established time frames.
10. Ensures physician OR time is fully utilized.
a. When OR cases are cancelled, reviews open cases to identify appropriate substitute.
b. Ensures patients have been cleared for surgery and willing to change surgery date.
c. Ensures authorizations are in place.
d. Monitors utilization, determines appropriate timing to release physician clock time, and then looks for division and department opportunitie to fill slots.
11. In addition to the above job responsibilities, performs other duties as assigned.
Position Compensation Range: $17.31 - $26.83 Hourly
Education: High school graduate or equivalent required. Associate's degree in a related field preferred.
Experience: Internal Candidates: Demonstrated proficiency in the duties of the Access Associate Senior role. External Candidates: 3 years of experience in a clinical setting (hospital, surgery center, or ambulatory clinic) in an administrative or clinical role required.
License/Certification: None required. Certified Healthcare Access Associate (CHAA) preferred.
Proficient communication skills across spoken and written domains. Adequate auditory and visual skills.
Attention to detail and ability to write legibly and compose messages clearly and concisely.
Completed coursework or on-the-job training in medical terminology and/or CPT-coding and/or anatomy.
Strong problem-solving skills.
Required computer applications: MS Office (Word, Excel, and Outlook) and Epic.
Must be able to understand and comply with policies and procedures.
Job requires sitting for prolonged periods, frequently bending/stooping, reaching (overhead, extensive), and repetitive: computer keyboard and mouse use. Attention to detail and ability to write legibly. Ability to lift/push/pull <20 lbs. May be exposed to chemicals, blood/body fluids, and infectious disease.
The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified.
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