Job Details

Job Description

Position Purpose:

All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI's vision to be among the kindest, highest quality health systems in the country.

This position is responsible for financially clearing all outpatient referrals as ordered by the referring provider. Financial clearing includes but not limited to, validating the order (following protocols designed by the departments the order is referred too), checking medical necessity, verifying insurance eligibility, obtaining authorization (when necessary), scheduling procedures/visits, pre-registration, communicating financial responsibility to patient, scanning documents, and noting all communication into patient chart.

Key Responsibilities

Outpatient Scheduling Representative:

1. Develops and maintains positive interactions with patients, visitors, medical staff, and employees, in accordance with KHI mission, vision, and values.
2. Protects patient information and hospital financial reimbursement by updating demographic information, verifying insurance information, and ensuring that all notification/authorizations are complete according to department policy and procedures.
3. Accurately pre-registers patients and consistently meets accuracy expectations of 98%.
4. Accurately validates orders per scheduling guidelines and verifies diagnosis codes are appropriate for ordered procedures.
5. Schedules procedures/visits in the appropriate area (department, imaging modality room, KHI location).
6. Utilizes designated tools and resources as directed (i.e. electronic medical record, AIDET, etc.).
7. Meets designated productivity standards to schedule cleared outpatient visits in a timely manner.
8. Works to increase upfront collections by communicating to the patient their co-pays/deductibles and documenting that information to secure collection.
9. Consistently demonstrates a willingness to assist co-workers in a courteous manner to support department efficiency.
10. Completes all assigned duties accurately and in a timely manner.
11. Ability to communicate effectively with others, to manage multiple priorities and tasks, to maintain attention to detail.
12. Knowledge of and ability to use computer hardware and software applications.
13. Knowledge of medical terminology, coding rules and guidelines preferred.

Required Qualifications

Education: High school graduate or equivalent

Experience: Six months or more of progressive work experience

Preferences

Experience: One year of hospital outpatient scheduling and/or insurance verification experience in a hospital setting.

Special Position Requirements

Exposure category II: Expected duties have possible, but not routine, potential for exposure to blood, body fluids, or tissues.

Other potential hazard(s): Possible exposure to chemical substances; possible exposure to hostile

individuals.