GENERAL SUMMARY/ OVERVIEW STATEMENT:



The Patient Services Coordinator II, under general supervision, provides administrative support to health care providers in a high-volume ambulatory setting, functioning as the primary interface between the patient and the providers. The emphasis is placed on the ability to organize priorities, complete tasks, manage confidential patient information, schedule patient appointments, and manage referrals and other managed care related issues, such as medication and insurance authorizations. Serves as an overall resource person for support staff.


This is a 40 hour, Monday through Friday position. Standard hours are from 8:30 - 5:00PM.



PRINCIPAL DUTIES AND RESPONSIBILITIES:



Performs all duties that are the responsibility of a Patient Service Coordinator I and able to support other PSCII positions. Cross coverage across administrative positions is expected so training of standard responsibilities for each position is provided.


Performs all check-in and -out functions, as outlined by the MGH/MGPO Front Desk Standards of Operations.


Provides support and information to providers to problem solve and manage complex administrative patient issues


Performs the daily management of encounter form processing and reconcilement.


Ensures the completeness of all forms and performs basic ICD-9 coding, as required to complete visit encounter forms for processing


Understands all HMO, Managed Care and other Third Party Insurers. Functions as a resource for patients around managed care plans, insurance and referral issues, with an ability to perform electronic insurance verification.


Assists with investigating and resolving issues relating to and arising from the referral and/or billing process, which interrupts the delivery of care to a patient or the reimbursement for services rendered. Addresses patient questions, complaints and concerns.


Under the direction of the practice manager, functions as a department resource for referral, authorization, and insurance issues, including but not limited to medical, neuropsychological testing, medication prior authorizations and mental based insurance prior authorizations. Remains current on the changing issues impacting the health care insurers.


Understands financial services and self-pay resources and provides patients with information as needed.


Triages and manages more complex telephone calls, utilizing courteous customer service skills.


Maintains confidentiality and privacy, which is consistent with HIPAA guidelines.


Completely performs and is a resource to other team members in all revenue enhancement activities, including but not limited to registration verification, co-payment collection, cash management, encounter form reconcilement, etc.


Coordinates the scheduling of diagnostic testing.


Coordinates and tracks referral appointments and visits.


Provides cross coverage for other Practice staff members for absences, vacations, etc. and during variations in workflow, as needed


Assists with training and orientation of new staff, where applicable.


Performs all other related tasks which would facilitate the flow of patients through the practice, or which would enhance the quality of service to patients.


Works on special projects as directed.



Qualifications

QUALIFICATIONS:



High School Degree Required.Associate's Degree in Secretarial Science/Business, or a Secretarial TrainingCertificate Program strongly preferred.


Minimum of 2 years work experience inmedical or health care related practice. Billing and/or managed careexperience, particularly mental health billing, is preferred.



SKILLS/ ABILITIES/COMPETENCIES REQUIRED:



Knowledge of computer skills necessaryto use appropriate modules of EPIC Cadence, and electronic medical record modulesas required.


Good command of the English language,including medical terminology


Exceptional organizational skills,flexibility to manage multiple tasks and the accurate attentive to details.


Ability to work independently or withina team environment


Excellent and effective interpersonaland communication skills


Demonstrated ability to workeffectively and courteously with various groups of patients, staff andproviders.


Demonstrated ability to problem solveand function as a resource to other members of the team, and resolve complexissues on behalf of the providers and the patients.


Demonstrated in-depth understanding ofmanaged care and all other pertinent insurance/medical coverage


Demonstrated knowledge of HIPAAConfidentiality and Privacy Policies


Demonstratedunderstanding of Disaster protocols to include: fire, safety and code calls, per the mandatory training, asoutlined by MGH and Joint Commission guidelines.



EEO Statement

Massachusetts General Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. Applications from protected veterans and individuals with disabilities are strongly encouraged.