Insurance Verify Rep Conciergo Monday - Friday Day Shift

ESSENTIAL FUNCTIONS: 

1_____  Communicate and provide assistance to the Registration staff, Insurance verifiers and Pre-registration department as needed.

2_____  Tasks need to be reviewed within specified time periods of receiving and completed according to established guidelines.  Tasks will have one of three possible urgency levels:

1. Urgent – needed in 24 – 48 hours.
2. ASAP – needed within 2 – 3 business days.
3. Routine – needed within 3 – 5 business days.

3_____  Schedules procedures, tests and ancillary services according to established protocols. Responsible for the timely and accurate completion of tasks with tests and procedures needing scheduled.

4_____  Displays patience and tact when effectively communicating with patients and/or family members, the provider and hospital personnel. Possesses and utilizes professional telephone techniques.

5_____ Prepares reports and other documents as required.

6_____  Consistently and accurately processes all Medicare scheduled tests through the Craneware program and communicates to the physician, patient and department the patients needing to sign ABN’s for tests that do not meet medical necessity.

KMG Centralized Scheduler ABR-OE Certified

Job Description

Page 2

7_____  Verifies orders are complete. 

1. When scheduling a test/procedure will annotate:
   1. Test that was scheduled.
   2. Pre-Certification/Prior-Authorization number.
   3. Name of person spoken to at insurance company.
   4. Patient instructions given for testing.
   5. Date, time, location of scheduled test.
2. When scheduling a consult/referral will annotate:
   1. Reason for consult/referral.
   2. Date, time, location of appointment.
   3. Name of person spoken to at specialist’s office.
   4. Patient instructions.
3. Notify ordering office via reply to task.

8_____  Explains office policies, procedures and instructions to patients and/or referring physicians, assisting patients with gathering of information, completion of forms and/or preps for medical testing.  Gathers required clinical documentation and forwards to specialist and/or testing facility.

9_____  Demonstrates and understands the importance of all staff members being prepared to take on additional duties or relinquishing existing duties in order to maintain efficient running of the program.

10____  Exhibits ability to multi-task and prioritize, performing duties in a timely, efficient and accurate manner.

NON-ESSENTIAL FUNCTIONS:

1. Maintains inter and intradepartmental work flow by fostering a spirit of cooperation and teamwork.

1. Attends required meetings and participates in team assignments as required.

1. Performs other duties as assigned.

1. Identifies situations requiring further investigation, resolving problems as they arise.

1. Demonstrates behaviors reflecting values of trust, quality, flexibility and teamwork in all job related functions.

1. Maintains a neat, clean and organized work area.

KMG Centralized Scheduler ABR-OE Certified

Job Description

Page 3

1. Assures protection and privacy of health information as attained through written, electronic or oral disclosure.

1. Protects patients and employees by adhering to infection-control and hazardous waste policies and protocols and maintains a clean working environment.

1. Must maintain and hold in confidence any and all information of patient,    personnel and office information.

1. Contributes to performance improvement activities at Kosciusko Community Hospital.

1. Some exposure to blood and bodily fluids: Exposure Control Level II.

JOB QUALIFICATIONS:

Education and Formal Training Required:

Must have successfully taken certification test to obtain ABR-OE.

Bi-lingual preferred but not required.

Experience Required:

Prior healthcare experience preferred.

License Required:

Must hold and maintain ABR-OE certification.

Working Conditions:

Normal office environment with little exposure to excessive noise, dust and temperature extremes. 

KMG Centralized Scheduler ABR-OE Certified

Job Description

Page 4

Other:

Demonstrates age appropriate competency skills and knowledge, ability to perform skills specific to patient population identified in unit specific skill list.   Ages of patients served in office include infant, child, adolescent, adult and geriatric.

Must have good verbal and written communication skills.

Must demonstrate ability to work in a fast paced environment.

Must demonstrate ability to concentrate and pay close attention to detail.

Must demonstrate ability to interact efficiently and in a supportive manner with persons of all backgrounds.

Must demonstrate excellent telephone skills and etiquette.

Proficient computer skills.