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JOB DETAILS

Scheduler/Insurance Verifier

Job Ref: 27939

Talent Area: Administrative/Clerical

Location:
Houston Methodist Willowbrook Hospital
Houston, TX 77070

Area/Department: Sleep Center

Employment Type: Regular

Job Type: Full-Time

Organization: Houston Methodist

Work Shift: 8a-5p

Work Week


This position is scheduled to work Monday-Friday



Company Profile

Houston Methodist Willowbrook Hospital opened its doors to Northwest Houston in December 2000. In May 2010, a major expansion on the 52-acre campus doubled the size of the hospital, brining more expertise, more state-of-the-art technology and more specialized care to the community. With 312 licensed beds, 15 operating rooms and over 1,800 employees, Houston Methodist Willowbrook Hospital was specifically designed to provide comprehensive, personalized care for the community.


Job Summary

JOB SUMMARY:  The Sleep Center Scheduler/Insurance Verifier works closely with the department leadership to ensure hospital policies and procedures are implemented with respect to patient registration, insurance authorization, and scheduling to the Sleep Center. The Coordinator is responsible for coordinating referrals for technical review of patient information prior to scheduling study. Coordinator communicates with referring physician's office to get all pertinent data needed for scheduling and authorization and will communicate with patient once authorization for study is recieved. Coordinator will be responsible for inputting and managing patient information in the EMR, communicate with patients regarding what to expect and confirmation for appointments, and communicate with Physician with patient's study date.  The Coordinator will manage a referral log of pre-certified patients to facilitate efficient management of Sleep Center schedule. The Coordinator will work with physician’s office to ensure all completed studies are communicated and reviewed in a timly manner.  

 

PRIMARY JOB RESPONSIBILITIES:

PEOPLE

1.  Schedules physician and diagnostic appointments.

2.  Acts as point person for department when manager/director is away from clinic. Assists covering Director with any issues that require resolution.

3.  Demonstrates the components of the ICARE values statement.

SERVICE

1.  Demonstrates highly developed usage and understanding of clinical assessment tools, documentation and analytical skills.

2.  Responsible for maintaining and entering data into the Center’s database.

3.  Coordinates with the care team to meet core patient needs.

4.  Maintains strict confidentiality of patient, employee and hospital information at all times.

5.  Works with DME follow up as time allows.

6.  Performs other duties as assigned.

QUALITY/SAFETY

1.  Maintains the Sleep Center's patient records and coordinates monthly internal audits to ensure the integrity of electronic medical record by all disciplines within the department.

2.  Ensures the appropriate documentation is present when closing charts at patient’s completion of treatment.

3.  Evaluates and assesses patient’s medical condition, using physician designed triage tools.

4.  Follows all safety rules while on the job.  Reports accidents promptly and corrects minor safety hazards.

FINANCE

1.  Tabulates monthly enrollment statistics and tracking.

2.  Facilitates scheduling, insurance verification, and registration of all patients to the Sleep Center; in addition to being responsible for coordinating all cash collections for insured and non-insured patients with Patient Access Services. Maintains communication with Patient Access Services to understand current processes and insurance plans in order to ensure admission system (HIS) requirements are always adhered to.

3.  Develops, maintains and reconciles supply levels of both clinical & non-clinical supplies to ensure operational & financial efficiency with respect to budget. Ensures outside vendors/invoices are reconciled and submitted for timely payment to Supply Chain/AP.

GROWTH/INNOVATION

1.  Assists leadership by providing input for process improvement.

2.  Participates in department projects; seeks opportunities to expand learning beyond baseline competencies with a focus on continual development of the Sleep Center.

3.  Fosters a positive and constructive teaching environment by engaging co-workers in learning opportunities that are valuable and in alignment with business objectives.

 

EDUCATION REQUIREMENTS:  High school diploma or GED equivalent required; some college hours preferred

 

EXPERIENCE REQUIREMENTS:

1.  Minimum of 3 years of public contact experience with 2 years of health care experience in patient access services functions, primarily with ancillary scheduling and registration.

2.  Minimum of 2 years of experience contacting insurance providers and verifying insurance.

3.  Must be familiar with managed care contract requirements as they pertain to pre-cert and authorization processes.

 

CERTIFICATES, LICENSES AND REGISTRATIONS REQUIRED:  N/A

 

SPECIAL KNOWLEDGE, SKILLS AND ABLITIES REQUIRED:

  • Medical terminology experience and applicability

  • Knowledge of computers with  Hospital Information System – ADT and Patient Management experience preferred

  • Ability to manage multiple tasks and phone lines at one time, in a fast paced environment

  • Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles

  • Requires highly effective communication skills

  • Requires highly effective time management skills

  • Requires ability to understand and implement protocols

  • Requires experience with computer database management

  • Requires Microsoft Office skills

  • Requires strong interpersonal skills


Equal Employment Opportunity

Houston Methodist is an Equal Opportunity Employer.

Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of  race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other characteristics protected by law.

VEVRAA Federal Contractor – priority referral Protected Veterans requested.