REPRESENTATIVE, OUTPATIENT SERVICES Job at Excela Health Corporate Services

Excela Health Corporate Services Greensburg, PA

Job Details

Description

$2,500.00 SIGN ON BONUS ELIGIBLE


Job Summary

Responsible for coordinating and maintaining a positive customer experience while performing pre-registration, registration, scheduling, and business office functions. Must possess excellent customer service and computer skills. Be able to interact in a friendly, professional manner with a wide range of patients, operations staff, therapists, physicians, and other departments within the Excela Health system. Attention to detail and the ability to work well under pressure is essential. Also must be able to function effectively in an environment where it is necessary to perform several tasks simultaneously, and where interruptions are frequent.


Essential Job Functions

  • Coordinates scheduling of patients for the Outpatient Rehab Department into appropriate scheduling system/EMR.
    • Optimizes patient and physician satisfaction, staff availability, and equipment utilization when scheduling appointments
    • Minimizes delay of evaluations as availability allows when scheduling outpatient appointments. Must schedule evaluations within departmental policy of 48 hours
      • When unable to meet scheduling policy must communicate with leadership timely
    • Responsible for rescheduling patients to maintain compliance with plan of care
    • Reports changes in patient volume to leadership
    • Responsible for collaborating with Therapists to ensure continuity of patient care
  • Fiscal Accountability. Hold self-accountable for departmental processes in order to obtain maximum reimbursement for services and the successful flow of the revenue cycle.
    • Assures proper identification of patients presenting for services following the proper departmental procedures.
    • Determines if necessary authorizations or referrals have been obtained; ensuring each order meets current published standards; etc.
    • Investigates and identifies patient-responsibility dollar amounts in order to successfully collect point-of-service payments when appropriate.
    • Collects and enters co-pay collection in EMR and E-cashiering as necessary
  • Customer Focus. Assesses customers' needs and considers customer in all decision-making processes to ensure a positive customer experience.
    • Greets the customer in a polite and professional manner whether face-to-face or on the phone, determines needs and responds appropriately and courteously.
    • Responds to customer issues (intra-departmental, inter-departmental, and public) timely and to the satisfaction of the customer.
    • Identifies and performs appropriate action in situations where it is necessary to obtain appropriate documentation for proper advancement through the revenue cycle.
    • Provides instructions and guidance for new patients to assure smooth services

  • Provides constructive feedback and clearly expresses ideas.
    • Interviews patients and/or their representatives in order to obtain accurate demographic, insurance, and claim adjudication information in a timely, courteous, professional manner.
    • Updates system appropriately and accurately, ensuring appropriate signatures are obtained and required authorizations/certifications/medical necessity guidelines are met.
    • Communicates with management all issues that impact the accurate, timely and complete accomplishment of all assigned tasks.
    • Identifies and communicates to management recommendations for process improvement.
    • Communicates all relevant information with rehabilitation technicians as therapists as needed.
    • Communicates with management when unable to comply with departmental policy on availability of evaluations in a timely manner.
  • Readily accepts and incorporates changes into daily activities.
    • Conforms consistently to all system changes; including insurance payer regulations.
    • Follows all department processes and policies as required and updated.
  • Motivation and Influencing. Influences and persuades others to build commitment to quality and a positive hospital experience.
    • Acts as a role model for peers by striving for excellence, displaying a positive attitude, Dignity and respect and actively supporting the team concept. Facilitates changes necessary and is a change agent as required.
    • Monitors and reports on individual productivity to assist in the evaluation of one's ability to organize and plan daily work in order to meet outcome-based criteria set by management.
  • Follows all quality initiatives as determined by department leadership
    • Continuous improvement initiatives
  • Departmental policies and procedures
  • Interfaces with physician offices, professional staffs and patients regarding insurances. Obtains appropriate referrals and troubleshoots issues related to authorization and treatment schedules to avoid delays in initiation or continuation of treatment.
    • Reports insurance information to including benefits and LCD to professional staffs/patients.
    • Communicates with Revenue Cycle Specialist to resolve an issue with authorization and limit patient care disruption.
    • Corresponds with insurances via AllScripts/EMR/fax, delivering plans of care and patient updates.
    • Works with Revenue Cycle Specialist to insure patient authorizations are received prior to assessment.
  • Maintains patient information and charges.
    • Scans patient information into EMR within the appropriate time frame.
    • Occasionally will enter manual charges when needed
  • Requests new 90 day accounts timely to registration
  • Makes all appointment reminder calls on a daily basis
  • Other duties as assigned.

Required Qualifications

  • High School Diploma, GED or higher level of education.
  • Strong leadership ability, good organizational skills, independent and critical thinking skills, sound judgment, and knowledge of legal aspects and liability of nursing practice.
  • Strong ability to communicate complex and/or controversial topics and concepts to a wide and diverse audience.
  • Knowledge of Payor/Insurance Benefits
  • Proficient Word and Excel skills

Preferred Qualifications

  • Medical Terminology
  • Minimum 1-2 years of admissions, scheduling, or business office experience

License, Certification & Clearances

  • Current Basic Life Support (BLS) approved curriculum of the American Heart Association (CPR and AED) program
  • Act 34-PA Criminal Record Check from the PA State Police system


Supervisory Responsibilities

  • This position has no direct supervisory responsibilities, but does serve as a coach and mentor for other positions in the department.

Position Type/Expected Hours of Work

  • Incumbent will be scheduled based on operational need (rotate shifts, standby, on-call, etc.).
  • Travel may be expected locally between Excela Health locations.

LEAN

  • Actively promotes a Lean work culture by performing team member duties to encourage consistent use of LEAN principles and processes, including continually seeking work process improvements. Recognizes the necessity of taking ownership of one’s own motivation, morale, performance and professional development. Strives for behavior consistent with being committed to Excela’s missions, vision and values.

AAP/EEO

  • Excela Health is an Equal Opportunity Employer. It is the policy of Excela Health to prohibit discrimination of any type and to afford equal employment opportunities to employees and applicants, without regard to race, color, religion, sex, national origin, age, marital status, non-job related disability, veteran status, or genetic information, or any other protected class. Excela Health will conform to the spirit as well as the letter of all applicable laws and regulations.
  • Ability to perform the Essential Functions listed on the Physical Conditions and ability to perform the Essential Functions on the Working Condition chart below.

Work Environment Effective March 2020 or during pandemic: goggles, face shield and mask are required according to CDC guidelines

When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.

Essential – Absolute Necessity.

Marginal – Minimal Necessity.

Constantly – 5.5 to 8 hours or more or 200 reps/shift.

Frequently – 2.5 to 5.5 hours or more or 32-200 reps/shift.

Occasionally – 0.25 to 2.5 hours or 2-32 reps/shift.

Rarely – Less than 0.25 hours or less than 2 reps/shift.


Physical Condition

Essential

Marginal

Constantly

Frequently

Occasionally

Rarely

Never

Extreme Heat

x

Extreme Cold

x

Heights

x

Confined Spaces

x

Extreme Noise(>85dB)

x

Mechanical Hazards

x

Use of Vibrating Tools

x

Operates Vehicle

x

Operates Heavy Equipment

x

Use of Lifting/Transfer Devices

x

Rotates All Shifts

x

x

8 Hours Shifts

x

x

10-12 Hours Shifts

x

x

On-Call

x

Overtime(+8/hrs/shift; 40/hr/wk)

x

x

Travel Between Sites

x

x

Direct Patient Care

x

Respirator Protective Equipment

x

Eye Protection

x

Head Protection (hard hat)

x

Hearing Protection

x

Hand Protection

x

Feet, Toe Protection

x

Body Protection

x

Latex Exposure

x

x

Solvent Exposure

x

Paint (direct use) Exposure

x

Dust (sanding) Exposure

x

Ethylene Oxide Exposure

x

Cytotoxic (Chemo) Exposure

x

Blood/Body Fluid Exposure

x

Chemicals (direct use) Exposure

x

Mist Exposure

x

Wax Stripper (direct use)

x

Non-Ionizing Radiation Exposure

x

Ionizing Radiation Exposure

x

Laser Exposure

x

Physical Demands

When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.

Essential – Absolute Necessity.

Marginal – Minimal Necessity.

Constantly – 5.5 to 8 hours or more or 200 reps/shift.

Frequently – 2.5 to 5.5 hours or more or 32-200 reps/shift.

Occasionally – 0.25 to 2.5 hours or 2-32 reps/shift.

Rarely – Less than 0.25 hours or less than 2 reps/shift.


Physical Condition

Essential

Marginal

Constantly

Frequently

Occasionally

Rarely

Never

Bending (Stooping)

x

x

Sitting

x

x

Walking

x

x

Climbing Stairs

x

x

Climbing Ladders

x

Standing

x

x

Kneeling

x

Squatting (Crouching)

x

x

Twisting/Turning

x

x

Keyboard/Computer Operation

x

x

Gross Grasp

x

x

Fine Finger Manipulation

x

x

Hand/Arm Coordination

x

x

Pushing/Pulling(lbs. of force)

x

x

Carry

<5#

5#

Transfer/Push/Pull Patients

x

Seeing Near w/Acuity

x

x

Feeling (Sensation)

x

Color Vision

x

x

Hearing Clearly

x

x

Pulling/Pushing Objects Overhead

x

Reaching Above Shoulder Level

x

x

Reaching Forward

x

x

Lifting Floor to Knuckle

###

x

Lifting Seat Pan to Knuckle

###

x

Lifting Knuckle to Shoulder

###

x

Lifting Shoulder to Overhead

###

x

When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)




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