Scheduling and Precertification Coordinator (Full Time)

About North Country Healthcare (NCH): 

​North Country Healthcare is a non-profit affiliation of four medical facilities, Androscoggin Valley Hospital, North Country Home Health & Hospice Agency, Upper Connecticut Valley Hospital, and Weeks Medical Center, located in the White Mountains Region of New Hampshire. NCH includes numerous physicians and medical providers at multiple locations. This leading comprehensive healthcare network which employs hundreds of highly-trained individuals delivers integrated patient care through three community hospitals, specialty clinics, and home health and hospice services. NCH remains committed to the health and well-being of the communities we serve. As a leader in a management position this role emphasizes advancing High-Reliability Organization (HRO) principles, embedding a culture of safety, accountability, and consistent high performance.​ 

Position Summary 

• The primary responsibilities involve assessing provider orders for completeness, scheduling patient services, verifying insurance coverage, obtaining pre-certification for services, pre-registration of patients and providing pertinent prep instructions to patients prior to the scheduled services. Utilization of, and documentation in, the Meditech electronic system throughout the process is required. 

Supervises 

• N/A 

Job Requirements 

• Education, Required Licenses/Certifications: 

• High school graduate with experience in customer service, computer entry, and multitasking clerical functions.  

• Prior experience in medical facility, reception or billing/insurance is preferred. 

•  
  Work Experience, Skills, Knowledge and Abilities: 

• Keyboard skills and familiarity with computer applications to business setting are required.  

• Strong interpersonal, organizational and multitasking skills are required.  

• Congenial, pleasant, friendly, helpful disposition is required, as this position involves continuous contact with the public, providers, other Hospital staff and insurance companies.  

• Knowledge of medical terminology is preferable.  

• Ability to interact with providers and other healthcare practitioners in a helpful, courteous manner is required. 

• Demonstrated ability to work in a team-oriented environment is required.  

• A bilingual background is an asset to the position. Familiarity with computer applications required.  

• Must have technical aptitude and a willingness to learn software applications used at AVH. 

Contacts 

• Patients, providers, staff, community agencies & advocates, regulatory agencies and visitors. 

Physical Requirements 

• Indicates the appropriate physical requirements of this job in the course of a shift. Note: Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position.

Essential Functions 

• Exhibits courteous and cooperative behavior towards patients, families, visitors, volunteers, students, peers, and providers. Anticipates service needs and proactively resolves issues. Consistently holds self and others accountable for meeting patient/customer service standards. Practices service recovery skills. 

• Works openly and collaboratively both inside and outside the department; promotes performance improvement. Follows through on statements and actions in a timely manner. Strives for excellence in all endeavors. 

• Encourages discussion and consensus building. Recognizes and adapts to different view points and opinions; values diversity. Uses “indoor” voice. Avoids interrupting others. Champions change and exhibits flexibility and adaptability. 

• Accepts responsibility for own actions, behaviors and decisions. 

• Consistently optimizes time efficiently and effectively. Reports to work promptly at the beginning of the work shift and prepares to begin work. Returns to work promptly from lunch and breaks. Completes work assignment and departs timely. In compliance with Absenteeism and Tardiness policy. 

• Is viewed as a resource in the department when dealing with issues of systems and resources and accomplishing tasks in the most efficient and effective ways. 

• Maintains excellent customer service skills, recognizing the needs of patients, families, visitors, as well as co-workers and other staff. 

• Acts as a liaison among physician practices, practitioners and contracted services related to patient services and to ancillary services. 

• Schedules therapy evaluations and treatments for outpatients. Monitors and utilizes Meditech Scheduling and ITS work lists to identify electronic orders for outpatient services. 

• Analyzes incoming orders for completeness of demographic information, pertinent history, presence of diagnosis, and appropriate ordering provider, as well as prior authorization. Enters correct wording when entering data into Meditech. 

• Scans paper patient requisitions at time of scheduling. 

• Upon receipt of a completed order (electronic or written), contacts the patient or patient representative in a timely manner to schedule patient services, ensuring efficient turnaround time. 

• Provides pre-appointment instructions to ensure patients are prepared for therapy. Is familiar with therapy and is able to provide time estimates and brief overviews of what to expect during therapy evaluations and treatments. 

• Directs detailed questions to appropriate clinical staff. 

• Enters all required data into the appropriate Meditech modules, verifies demographic and insurance information, and revises it as necessary. 

• Tracks Medicare certifications, counts number of visits for all insurances including end dates, no-shows and cancellations. 

• Assists with compilation of data and reports. 

• Performs monthly stats reconciliation. 

• As assigned, makes appointment reminder calls to patients, and pre-registers patients by telephone when possible. 

• Registers and/or pre-registers patients. Completes Medicare questionnaires and notifies Patient Financial Services of possible liabilities. 

• Contacts insurance companies to verify benefits and coverage levels, as appropriate. 

• Verifies if pre-certification is required and, if so, obtains authorization and enters detailed information into Meditech ARM application. 

• Refers possible payment issues to the Customer Service Department. 

• Maintains familiarity with all Meditech applications required to perform duties. Applications include, but are not limited to, Community Wide Scheduling, Authorization and Referral Management, Scanning and Archiving, Billing/Accounts Receivable, etc. 

• Makes Senior Outreach Therapist aware of any patient backlogs or scheduling/resource issues. 

• Maintains current knowledge of CPT and ICD-10 coding practices as needed to perform job functions. 

• Maintains familiarity with insurance carrier pre-certification requirements through bulletins, updates, online tools, and other available resources. 

• Maintains work area in a clean and orderly manner. If time permits, ensures beds are made up before the first patient of the day. 

• Picks up and delivers mail. Collects and/or sends faxes. 

• Records and maintains staff meeting minutes. 

• Collects co-pays and appropriate payment at the time of service. 

• Files charts and paperwork. Prepares tracking sheets for the next day. 

• Enters schedules into Meditech, including coverage/time-off. 

• Performs (or delegates) reminder phone calls. 

• Hands out objective measurement tools (ie., ODS and LEFS) to patients and prints them from the Repository. 

• Works as a cohesive member of the North Country Outreach Rehab Clinic Team, sharing the workload for scheduling, pre-registration, insurance verification, pre-certification, and other duties with her Point of Service back-up person. Performs other tasks as assigned by Senior Outreach Therapist. 

• Proactively utilizes slow periods in a creative and business-minded manner, performing tasks such as organizing, sorting, reviewing own and/or therapists work for accuracy, offering assistance to a coworker, cross-training, etc. 

• Demonstrates technical aptitude. Is familiar with computer applications. Is willing to learn software applications. 

• Discharges therapy charts in a timely manner and scans all the information into the system. 

• Audits all therapists daily for correct charges and notes, and verifies synchronization with scheduling. 

Non-Essential Functions 

• Performs routine typing and clerical functions. 

• Assists with general office and clinic housekeeping duties as needed. 

• Maintains familiarity with the operation of all business office equipment necessary to perform duties. 

• Orders supplies for the proper functioning of the North Country Outreach Rehab Clinic. 

• Performs additional duties as assigned by the Senior Outreach Therapist.