General Summary

Our Outpatient Services Department takes a team-based approach to providing outstanding patient experience and care. Our ASCs build individual relationships with each patient, provide a hands-on approach to care coordination, and ensure that each patient is happy with their experience.

Ambulatory Service Coordinators (ASCs) are an integral part of our Outpatient Services team. They are the point of entry for patients who receive outpatient services at the hospital. ASCs and are primarily responsible for effectively, efficiently, and accurately collecting, communicating, and documenting all of the relevant and requisite information that is needed to schedule, treat, bill, and support the patient. ASCs provide a level of customer service and care coordination that delivers an experience that is clear, positive, and reassuring to the patient.

ASCs build trust and rapport with each patient while ensuring that they receive the appropriate care and follow-up. ASCs advocate for our patients by helping them navigate the entire outpatient process with a hands-on and above and beyond approach; from arrival, to registration, to scheduling, to insurance authorizations/verifications, to communicating with the patients primary care physician, and assisting with questions about billing. ASCs also physically assist the patient and their family members/guests in reaching their appropriate destination in the hospital. ASCs communicate and collaborate across departments and teams, including but not limited to: Heart of Rose outpatient clinic, COVID clinic, radiology, cardiology, surgery, wound care, OB/GYN, laboratory services, Emergency Department, behavioral health/psychiatric, social work, transportation, pharmacy, finance, medical records, and community outreach. ASCs work as a team with their fellow ASCs throughout the Outpatient Services Department in order to provide staffing support, engage in solution-oriented communications and activity, escalate challenges, and deliver a patient experience aligned with RCHs mission and vision.

In every interaction with patients, visitors, physicians, and team members, ASCs will exemplify RCH Core Values and Pillars, in their performance and behavior, while demonstrating an understanding and commitment to providing timely, accurate, and complete documentation and care coordination.

ESSENTIAL JOB FUNCTIONS

• Enter all demographic information accurately, as obtained by the patient or via referral, into the patient billing system and other required applications.
• Schedule appointments and work across departments to ensure follow up.
• Provide excellent telephone and in-person customer service: answer and return telephone calls promptly and courteously; triage phone calls to the appropriate person or department; respond to requests in an accurate and timely manner.
• Handle all inbound and outbound calls; including those that constitute outreach or follow-up calls; i.e. appointment confirmations and reminders, and new patient scheduling.
• Speak to all referral sources, gather and enter intake information into the computer system.
• Communicate with third party payers to determine insurance benefits/self-pay status authorization at the time of intake. Coordinate with other departments in the facility as needed to ensure the patients will receive appropriate authorization, care, and follow-up.
• Mange your time and activities in an effective and efficient manner while respecting the time and workload of fellow team members. Organize daily activities to assure the department functions according to accepted standards.
• Provide a level of customer service that delivers an experience that is clear, positive, and reassuring to the patient

• Establish and maintain effective internal and external working relationships. Responsible for compiling and organizing all information according with privacy/ confidentiality policies and regulations.
• Drive clinical and financial excellence through accurate and timely documentation, communication, follow-up, and problem-solving.
• Take ownership of each patient and team member interaction. Identify problems ahead of time and communicate and escalate as needed.
• Be solution-oriented in all daily activities while working across departments.
• Obtain insurance eligibility and benefits information using various phone and on-line resources. Maintains appropriate authorizations and notifies insurance companies of patient arrival as needed. Ensures eligibility and authorization requirements are completed within the required timeframe.
• Accurately enter and submit insurance verification request through appropriate application by scanning documents into the system.
• Accurately enter referral information, gathered from patient or referral, into the appropriate applications; including information related to authorizations.
• Work all related queues to ensure timely response to referrals, requests, and resolution of errors.
• Follow all hospital, ACHC (formerly HFAP), and other compliance/regulatory policies and procedures.
• Perform other duties as assigned by management.
• Reports to the Director of Outpatient Services.

KNOWLEDGE, SKILLS, ABILITIES REQUIRED

• Experience with Medicare/Medicaid and other commercial insurances, preauthorization and utilization management.
• Safety net hospital, FQHC, or Medicare/Medicaid primary care clinic experience.
• Customer service experience and exceptional interpersonal relations and communication skills; both written and verbal.
• Demonstrated experience working effectively in time-sensitive situations, handing multiple priorities simultaneously, and ability to make prompt decisions while providing hands-on and above and beyond approach to patient experience.
• Data-driven (and detail-oriented) but people-centered.
• Flexible with a willingness to learn and be adaptable as situations demand.
• Experience in Meditech or other hospital or outpatient EMR system.
• Demonstrated commitment to timeliness and personal organization and solution-oriented thinking.
• Team player with a service heart.
• Familiarity with medical billing and medical terminology. Familiarity with coding CPT, ICD-10, a bonus.
• Must be proficient in Microsoft Office Software (Work, Excel, and Outlook).