(List in order of importance or percentage of time spent on the particular responsibility - High to Low)
Act as a resource to Scheduling Specialists for all PAC guidelines, processes and applications
Train new hires to department standards and processes. Assist with ongoing training and education of staff
Take escalated calls and complaints from patients, family members, insurance companies or other entities
Assist with delegation of outbound call list and tracking
Accurately schedule for Specialty and PCP practices and correctly handle complex rule sets across multiple Medical Groups and Markets
Maintain optimal productivity for call handling and wrap-up.
Ensure and request appropriate referrals and/or authorizations are present for specialty care. Maintain knowledge of insurance-specific referral and prior authorization requirements.
Follows scheduling protocols and guidelines. Utilizes critical thinking to determine which processes to apply to specific situations.
Determine calls with urgent needs and complete warm transfer to clinic staff
Researches patient requests in the medical record and provides information to patient or other entity.
Monitor inboxes in EMR to ensure return communication from the clinic is handled promptly
Obtain information regarding refills, clinical questions, referrals, services, etc. Enter documentation and communication within EMR for non-urgent clinical calls
Set a positive example for other Scheduling Specialists as it relates to job performance and expectations. Maintain professional communication standards through verbal and electronic communication methods.
Collects insurance and pre-certification information from callers, validates insurance eligibility and correct PCP assignment
Adheres and complies to all policies and procedures
Attend educational sessions and department meetings as scheduled
Ability to perform all other duties as assigned or requested
Internal Number: 15917577
About Northwest Medical Center
For Northwest:Northwest Medical Center is a 300-bed community hospital with comprehensive inpatient and outpatient services, ranging from emergency to cardiac, critical care, labor & delivery and beyond. We are nationally accredited in several areas including stroke, chest pain, heart failure and joint and spine surgery. Our mission is to provide the communities we serve with high-quality cost effective and safe health care.For Oro Valley:Oro Valley Hospital has been nationally recognized for its quality care including designation as a Chest Pain Center, NICHE, PEDS "Pediatric Prepared", Primary Stroke Center, STEMI Receiving Center and Trauma Level IV. That coupled with a beautiful hospital in a scenic location makes Oro Valley Hospital an exceptional place to work.