Responsible for managing incoming referrals, reaching out to new patients, and accurately scheduling then registering patients by gathering and entering patient demographic and insurance information into the electronic health record (EHR). The Office Specialist will promptly answer and direct incoming phone calls in addition to greeting arriving patients presenting for service. The Office Specialist is responsible for processing and collecting payments when indicated. The Office Specialist provides outstanding customer service; treating all patients and their families with compassion and sensitivity.
Essential Duties and Responsibilities: The following list is not all inclusive as the position will assist with special projects or other duties as assigned by supervisor.
- Supports the organization’s mission and goals and quality standards. Embraces KANA’s culture of serving the whole person through our provision of services. Incorporates KANA’s core values of Courtesy, Caring, Respect, Sharing, and Pride in all activities and decisions.
- Upholds KANA’s Code of Ethics by conducting professional activities with honesty, integrity, respect, fairness, and good faith in a manner that reflects positively upon the organization.
- Greets all patients in a courteous and helpful manner whether by phone or upon check-in to clinic. Promptly and courteously answers multi-line phones by the third ring, directing calls to appropriate staff member or department as needed. Responds to eligibility and third-party payer questions in a helpful and professional manner.
- Accurately schedules all therapy department appointments ensuring scheduling guidelines are followed. Works collaboratively with clinical staff and other health care teams to facilitate patient care appointments. Effectively manages provider schedules daily, assesses flow of patients, and reschedules patients as needed and/or requested. Place reminder phone calls to patients with upcoming appointments.
- For every encounter, screens the patient for changes in demographic information, eligibility for treatment as a beneficiary, and eligibility for third party payment of services; ensuring all data is complete and accurate in electronic health record.
- Reviews registration for missing data and ensures all required fields are accurately entered before or when patient arrives.
- Ensures EHR system accurately reflects current and correct insurance information. This may include obtaining appropriate signatures, assisting with the collection of CIB and insurance documentation, as well as scanning the collected information into the patient’s electronic health record.
- During initial scheduling/registration process, completes patient insurance eligibility and benefits verification prior to scheduled visits. Facilitates prior authorization process before scheduled visits and accommodates requests during visits as the need arises. Manages and organizes authorizations ensuring coverage for all visits.
- Communicates with the Insurance and Billing Specialists regarding any changes or recent additions to the schedule for the current day.
- When patient calls for an appointment or arrives for service, compares registration data or paperwork with sliding fee scale to determine eligibility. Follows up with patients regarding required documentation for sliding fee eligibility or need for CIB. Notifies patients of responsibility for any payment related to billable services, including co-payments, sliding fee payment, and payment plans before the patient arrives or upon arrival. Review the notes for relevant information when checking the patient in for service.
- Collects payments from patients in accordance with clinic guidelines to ensure all billable services are prepaid, including co-pays and sliding fee payments. This may be done over the phone in advance of the patient arrival. Documents all pre-arrival activities in registration including items that may need to be completed upon the patient’s arrival.
- Handles cash, checks and credit cards making change as needed; reconciles cash box/drawer at the beginning and end of the day following established procedures and guidelines. Refers patients to the Alternate Resources Specialist or Insurance and Billing Specialist as needed or when directed.
- Manages incoming referrals for the rehabilitation services department, which includes using an electronic medical record and scheduling/referral management software, following complex workflows with multi-step instructions, and maintaining Excel files. Regularly communicates with therapists, medical care teams and patient navigators, and schedulers to improve patient access and ensure correct scheduling.
- Tracks data as required by the Director of Rehabilitation Services and the Rehabilitation Services Office Manager to improve clinic flow and patient care. Assists with improvement of current front desk practices and with development of new practices as needed. Proactively prevents gaps in care with patient tracking and communication with therapists.
- Coordinates travel for therapy patients with travel specialist, ensuring correct documentation and paperwork is completed by the therapist.
- Coordinates with village clinic staff to arrange PT in the village clinic days, telehealth, and ensures that patients residing in the village are aware of appointment times and travel needs are met.
- Communicates effectively and appropriately with patients, colleagues, and other KANA staff. Practices meaningful customer service skills addressing patient and staff needs courteously, promptly, and with compassion.
- Maintains up to date knowledge of and be prepared to explain KANA’s privacy practices, purchased and referred care processes, alternate resources requirements, sliding fee discount program, and other health and community services offered.
- Strictly adheres to the provisions of the Privacy Act, HIPAA, and KANA policies.
- Monitors the waiting area, watching for patients who have arrived but may have forgotten to check-in or who have checked-in but have been waiting for a longer than anticipated time. Cleans and organizes waiting area throughout the day.
- Maintains front office inventory and equipment by checking supplies, anticipating needed supplies, and placing orders for supplies as needed or directed.
- Cleans and organizes therapy equipment and do laundry as needed.
- Sets up patients on exercise equipment as instructed by clinicians; training provided.
- May be cross-trained on Wellness Center duties in order to provide desk coverage for meetings and other events.
Supervisory Responsibilities: This job has no supervisory responsibilities.
Requirements
High school diploma or general education degree (GED) and three years’ experience working with the public in an medical office setting; or equivalent combination of education and experience. Knowledge of HIPAA, and other state and federal regulations governing healthcare practices, and experience with Medicaid, Medicare and commercial insurances.
