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Presbyterian Healthcare Services PATIENT VISIT SPECIALIST-ABQ - HS GENERAL SURGERY in Albuquerque, New Mexico

  • Performs visit closure activities to coordinate patient care while providing an exceptional patient experience for successful completion of next steps ordered by the clinician

  • Advanced scheduling for specialty or radiologic procedures

  • Recognizing payor requirements and obtaining prior authorization/certification/referrals for visits/procedures

  • Processes daily referral workqueues for authorization, deferring only those that require payor consideration

  • Primary Care and most Specialty Care offices must process STAT and ASAP referral workqueues for results received

  • Return scheduling knowledge to include the ability to scrub schedules for accuracy and efficiency in home department

  • Monitor in-baskets and reports for overdue results, waitlisted appointments, recalls, etc

Responsibilities:

Customer Service and Caring Practices:

  • Achieve exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools.

  • Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times

  • Ability to manage conflict and appropriately request the help of a supervisor when needed

  • Fosters effective patient relations with patients, the public and providers by listening, responding and escalating when appropriate

  • Round with patients waiting to insure their comfort and to inform of delays when applicable

Encounter Components:

  • Review and follows order entered into the EHR by the clinician

  • Schedule return visits lab, radiology, STAT & ASAP appointments and advanced imaging

  • Obtain Prior Authorization/Referral per payor protocols

  • Validates patient MyChart Access

  • Prints AVS as applicable with double check for HIPAA privacy

  • Collects any backend patient balance such as high deductible

  • Communicates effectively to ordering clinician when any restriction, such as access, restricts or prohibits scheduling as ordered

Financial Accountabilities:

  • Refers as appropriate to on site Financial Advocate, or for uninsured to the Financial Advocacy Center

  • Validate prior authorization/certification/referral are secured PRIOR to a scheduled procedure or test, alerting stake holders (patient, patient representative, OR, etc) if a breakdown occurs

Message Management:

  • Formulates complete and accurate telephone encounter messages and routes to the appropriate Epic in-basket pool to support operational aspects of patient care.

Medical Record Components:

  • Instructs patients on the Release of Information process and insure a fully completed ROI Form is submitted to Health Information Management for incoming or outgoing records

Patient Relations

  • Comprehend quality service connection to patient satisfaction and reimbursement

  • Participate in metric goals for telephones performance metrics, TSF and abandonment rate when applicable

  • Perform confirmation calls when applicable to include directions and instructions as required by the visit type

Patient Safety

  • Respond quickly to patients showing distress. Follow guidelines set forth by the Clinic Manger to alert the clinical team. Assist in any manner the clinic team directs.

  • Ensure check out area, waiting area and walkways are clear of any unnecessary items and are clean and neat.

  • Report any concern that may create a safety issue.

  • Annual competency completion of Clerical Staff during a Code Blue

Quality Improvement:

  • Appointment reminder calls

  • Rescheduling

  • Evaluate provider schedules and take appropriate action to ensure accuracy and efficiency per guidelines

  • Works with assigned physicians to maximize schedule effectiveness

C.A.R.E.S Behaviors:

  • Demonstrates CARES behaviors of Collaborate, be Accountable, Respect, Engage and Serve to all whom you encounter.

Academic Preparation:

*High school or equivalent

*Short-term training in Medical Terminology

*Familiarity with CPT and ICD-10 coding

Experience:

*Minimum 18 months experience in a medical office setting with significant MD interaction

*Proficiency in prior authorization/certification/referral process

*Must pass EPIC competency for Registration at completion of Epic Clerical

Training class

Professional Requirements:

*Pass annual competency exam for all areas of responsibility.

*Attend Quarterly MSO meetings.

*Attend Staff meetings

*Attend Employee Forums

Abilities:

*Requires strong organizational and multi-tasking skill sets

*Significant customer service skill set paramount

*Must be able to function under pressure while maintaining professionalism

*Working knowledge of CPT and ICD-10 coding

*Pass annual competency exam for all areas of responsibility.

*Attend Quarterly MSO meetings.

*Attend Staff meetings

*Attend Employee Forums

Benefits

Benefits are effective day-one (for .45 FTE and above) and include:

  • Competitive salaries

  • Full medical, dental and vision insurance

  • Flexible spending accounts (FSAs)

  • Free wellness programs

  • Paid time off (PTO)

  • Retirement plans, including matching employer contributions

  • Continuing education and career development opportunities

  • Life insurance and short/long term disability programs

About Us

Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Requisition ID: 2021-24816

Street: 1100 Central Avenue SE

JobTitle: PATIENT VISIT SPECIALIST-ABQ - HS GENERAL SURGERY

City: Albuquerque

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