Presbyterian is seeking a Patient Visit Specialist.
In this position, you will coordinate patient care and ensure an exceptional patient experience, schedule specialty and radiologic procedures, obtain prior authorizations, certifications, and referrals as required by payors, process daily referral workqueues for authorization, deferring only those needing payor consideration, handle STAT and ASAP referral workqueues for Primary and Specialty Care offices, scrub schedules for accuracy and efficiency, and monitor in-baskets and reports for overdue results, waitlisted appointments, and recalls.
Type of Opportunity: Full Time (1.0 FTE/40 hours per week)
Work Schedule: 8 hour days
Presbyterian is committed to an inclusive and equitable environment where everyone is valued and empowered for success. We believe that our environment should reflect the diversity of our community.
How you grow, learn, and thrive matters here.
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Responsibilities:
Customer Service and Caring Practices:
* Achieve exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools.
* Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times
* Ability to manage conflict and appropriately request the help of a supervisor when needed
* Fosters effective patient relations with patients, the public and providers by listening, responding and escalating whenappropriate
* Round with patients waiting to insure their comfort and to inform of delays when applicable
Encounter Components:
* Review and follows order entered into the EHR by the clinician
* Schedule return visits lab, radiology, STAT & ASAP appointments and advanced imaging* Obtain Prior Authorization/Referral per payor protocols
* Validates patient MyChart Access
* Prints AVS as applicable with double check for HIPAA privacy
* Collects any backend patient balance such as high deductible
* Communicates effectively to ordering clinician when any restriction, such as access, restricts or prohibits scheduling as ordered
Financial Accountabilities:
* Refers as appropriate to on site Financial Advocate, or for uninsured to the Financial Advocacy Center
* Validate prior authorization/certification/referral are secured PRIOR to a scheduled procedure or test, alerting stake holders(patient, patient representative, OR, etc) if a breakdown occurs
Message Management:
* Formulates complete and accurate telephone encounter messages and routes to the appropriate Epic in-basket pool to supportoperational aspects of patient care.
Medical Record Components:
* Instructs patients on the Release of Information process and insure a fully completed ROI Form is submitted to Health InformationManagement for incoming or outgoing records
Patient Relations
* Comprehend quality service connection to patient satisfaction and reimbursement
* Participate in metric goals for telephones performance metrics, TSF and abandonment rate when applicable
* Perform confirmation calls when applicable to include directions and instructions as required by the visit type
Patient Safety
* Respond quickly to patients showing distress. Follow guidelines set forth by the Clinic Manger to alert the clinical team. Assist inany manner the clinic team directs.
* Ensure check out area, waiting area and walkways are clear of any unnecessary items and are clean and neat.
* Report any concern that may create a safety issue.
* Annual competency completion of Clerical Staff during a Code Blue
Quality Improvement:
* Appointment reminder calls
* Rescheduling
* Evaluate provider schedules and take appropriate action to ensure accuracy and efficiency per guidelines* Works with assigned physicians to maximize schedule effectiveness
C.A.R.E.S Behaviors:
* Demonstrates CARES behaviors of Collaborate, be Accountable, Respect, Engage and Serve to all whom you encounter.Other Information
Academic Preparation:
We're all about well-being, starting with yours.
Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.
Learn more about our employee benefits.
Presbyterian is committed to an inclusive and equitable environment where everyone is valued and empowered for success. We believe that our environment should reflect the diversity of our community.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system comprised of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 13,000 employees - including more than 1,200 providers and nearly 3,500 nurses.
Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.