The MI Scheduling Scheduler functions under the direction of the Scheduling Supervisor/ Manager and Diagnostic Outreach VP. Provides outstanding customer service to customers in a fast paced busy environment. Drive system wide volumes by scheduling Medical Imaging appointments via inbound and/or outbound telephone calls or in person. Observing Quality and Productivity standards and other Key Performance Indicators. Responsible for performing a wide variety of clerical procedures that requires independent judgment, ingenuity and initiative in the utilization of computers and other equipment. Knows the existing lines of communication and authority, handles communications properly and is dependable and cooperative. Works with staff and understands appropriate scheduling process, willing to learn procedures/patient preps. Assist physician's office staff with scheduling issues in a timely manner. Handle heavy phone volume. Must be flexible with work hours to meet department needs.
Core Responsibilities and Essential Functions:
Scheduling Duties
Knowledge of all Medical Imaging exams in all modalities, including patient preps and instructions.
Demonstrate understanding of Medical Imaging Procedures.
Knowledge of Diagnosis codes or reasons for procedures
Knowledge of testing frequencies based on insurance and Medicare guidelines.
Knowledge of various insurance programs offered by each carrier
Knowledge of Medicare guidelines regarding exams that require Medical necessity checks (Follow ABN process)
Knowledge of insurance carriers requirements for Pre-Authorization of procedures and referrals for procedures (Referring to Insurance Quick Reference guide).
Knowledge of the lead time required by an insurance carrier to process pre-auth referral numbers.
Knowledge of all Medical Imaging facilities hours of operation.
Asking exam pre-screening questions to ensure that a patient meets criteria or does not have conditions that would contra-indicate the test being performed.
Knowledge of which Medical imaging exams require specialized Radiologists and able to coordinate that with the schedule to make sure the patient is scheduled at the correct facility.
Assist the physicians office with ICD-9 and ICD-10 codes for Medicare Medical necessity by referring to the coding helpline
Schedule procedures for Cardiopulmonary (Echocardiograms)
Knowledge of EMR, Fax and Email orders
Working Knowledge of working with orders in the Medical Imaging Schedule Orders Work Queues
Knowledge of electronic orders (Image Now, Trace) and attaching paper orders to scheduled appointments.
Handle heavy phone volumes, providing appropriate telephone etiquette and scripting
Ability to type with a high degree of accuracy and computer skills to accurately input data into scheduling software.
Excellent communication and interpersonal skills to effectively obtain required minimum data set from patients, their representatives and/or physician offices; obtains verifies and updates demographic and insurance information, accurately completing scheduling questionnaires. Verify payors through real-time eligibility, if applicable. Non-RTE payors must be verified via web or phone.
Verify the accuracy of data entered and correct any errors
Superior attention to detail
Ability to exercise judgment in taking appropriate actions in emergent situations, take initiative when problem solving, retain composure in stressful situations and escalate issues as necessary
Maintain neat attire, hair and appearance, following the department dress code.
Team Player
Ability to interact respectfully with co-workers, patients, referring office staff in a friendly, personable and professional manner
Promote positive working relationships with co-workers, Team Leads, Supervisors and Managers.
Orientates new employees and assures proper documentation of training
Assists other areas of Scheduling when needed
Flexible with hours to meet department needs
Assist in the interview process of new hires if asked
Understands existing lines of communication and authority, handles communications properly and is dependable and cooperative
Meets Service Recovery and Customer Service guidelines as needed
Performs other duties as assigned
Complies with all WellStar Health System policies, standards of work, and code of conduct.
Required Minimum Education:
High school diploma Required or equivalent. Required
Required Minimum License(s) and Certification(s):
All certifications are required upon hire unless otherwise stated.
Required Minimum Experience:
Minimum 1 year of experience in customer service or medical scheduling Preferred
Required Minimum Skills:
Strong customer service skills, good communication and organizational skills. Basic insurance carrier and pre-certification knowledge and computer skills preferred. Basic typing and data entry experience. Medical Terminology preferred. The individual must be able to communicate and understand verbal and written English language and display a positive attitude. This position requires a high level of attention to detail and a low error rate, as the consequences of even a minor mistake can be significant for patients and providers. In addition, this position requires regular, reliable attendance.