Essential Functions:Perform duties under moderate supervision with intermediate to advanced proficiency in administrative skills.
Act as a super user for scheduling, registration, and billing systems. Provide training and assistance to others in these areas.
May perform more complex or specialized functions (i.e. surgical scheduling) at highest competency level.
Utilize knowledge of HMO's, managed care and other thirst party insurers, and troubleshoots insurance issues as appropriate.
Assist with training and orienting staff as needed.
Provide cross coverage as needed.
Assist with special projects as directed.
Follow HIPAA guidelines for the management of patient privacy and confidentiality.
Other duties, as assigned
The Practice Assistant II position is responsible for the day-to-day patient and customer interactions within the Dermatology unit located at 221 Longwood Avenue. Working under the direction of the Practice Coordinator and the Practice Manager, the Practice Assistant II is the front line of patient contact within the practice. The role is a vital role, having both significant impacts on patient care and satisfaction, clinical operations and clinical revenue. The Dermatology practice at 221 Longwood Avenue generates in excess of 26,000 patient visits and is presented with more than 72,000 patient phone calls per year.JOB SPECIFIC DUTIES AND RESPONSIBILITIES: Job Specific StandardsWarmly greets all patients, customers and visitors into the practice. Ascertain whether the patient or the customer has an appointment.
During the arrival process, distribute relevant institutional and practice specific forms, including patient self assessment information form, patient information questionnaire, and patient medication and allergy review form. Requests electronic signature for all applicable institutional forms, including HIPAA notice of privacy, Mass HIway consent, hospital consent for treatment, and missing referral waiver form.
- For all patient appointments, verify the patient's identity using 2 BWH acceptable identifiers. Verify the patient's appointment time and provider.
- Arrives the patient in the BWH scheduling system in accordance with the department's guidelines.
- Alert clinical support staff of any special needs or special attention needed for arriving patient, including fall risk, patient special needs or VIP patient.
- Coordinates patient arrival with interpreter services department as necessary
- For any patient who does not have a scheduled appointment, work within the established practice protocols to determine how best to serve the patient's needs.
- For other appointments, notify the appropriate party regarding the customer or visitor's arrival.
Requests that each patient verifies the accuracy of all demographic and insurance information on their file and provide instructions as to how updates can be made. Identify patients who are not able to perform this task and offer to provide assistance. Collect payments due at the time of service, in accordance with the department's patient payment collection policy.
- Able to address any questions that a patient may have regarding any of the institutional or practice specific forms.
- Document electronically in system any time a patient refuses to sign requested forms
Coordinates managed care related activities for all patient appointments
- Determines whether patient is responsible for a copay for visit and the amount of the copay due
- Collects payments for cosmetic services rendered
- Enter payments into BWH scheduling system as well as approved online banking transaction system
- Issue receipts for all payments collected
- When payment is not collected for all balances owed on cosmetic procedures, coordinate appropriate follow-up activities.
- Ensure that payment batches are completed in accordance with criteria established by the Department's patient payment collection policy
Direct patients to the appropriate waiting area and provide a brief explanation of what they should expect. Communicates wait time expectations. Monitor the waiting room and coordinate with practice's clinical support staff to ensure that customers are appropriately served in a timely manner.
- Determine patients who do not have valid insurance information on file. Communicate to patient need to update insurance to ensure billing accuracy of visits and procedures
- Calls BWH Patient Service Center on patient's behalf in order to update insurance plan information as necessary
- Determine patients who do not have valid insurance referrals in place. Communicates need for referral with patient and gives instructions on how to obtain insurance referral.
- For patients who do not have a valid insurance referral on file for date of service reviews BWH missing referral and prior authorization waiver form and requests patient's signature
During the check-out process, assume primary responsibility for scheduling patient follow-up appointments in the Department of Dermatology, coordinating with other department practices as necessary. Coordinate any outside patient appointments or services requested by the physician, including radiology, lab services, referrals to other BWH departments or referrals to outside medical facilities.
- When there are potential service or process breakdowns, attempt to remedy the situation. When this is not possible, immediately inform a member of the team who is able to quickly resolve the issue.
- Provide updates to patients and other customers regarding delays, including providing updates when the duration of a previously communicated delay has changed significantly.
- Maintain the waiting area throughout the day to ensure that its appearance meets appropriate customer service and safety standards.
- Ensure the patients' questions are appropriately answered and /or that appropriate follow-up is provided.
Assume primary responsibility for scheduling patient appointments. Assist in increasing customer satisfaction by appropriately managing the appointment schedule and access to clinical services.
- Review patient encounter forms for indication that additional services are required (including such things as follow-up appointments, ultrasound, CT scan, pre-surgical testing, cardiology procedures, x-rays, lab tests, hospital admissions or procedures, etc.)
- For follow-up appointments in the practice, offer to schedule appointment. Do not ask patient to call the office to schedule a follow-up appointment.
- For follow-up appointments in other BWPO or BWH practices or other facilities, contact the practice directly to facilitate scheduling the necessary appointment(s). Communicate and confirm orders, obtain instructions for patient, and when possible, scheduled appointments.
- Coordinates and schedules follow up appointment(s) with interpreter services as necessary
- In accordance with Practice protocols, prepare any necessary paperwork or instructions related to follow-up care.
- At the close of the encounter, thank every patient.
- Works closely with each physician to ensure that scheduling of patient appointments is done in accordance with their preferences and scheduling templates.
- Maximize the utility of the scheduling application by accessing all available scheduling data and resources. Utilize the scheduling application in a manner that supports optimal access, appropriate appointment arrangements, and thorough documentation of relevant requirements. Obtain all necessary information in order to ensure that the patient is scheduled with the most appropriate provider.
- If the next available appointment exceeds a reasonable timeframe (as established by the Practice), or if the patient or referring physician expresses concern with the wait times for an appointment, offer to investigate other scheduling opportunities. Work with practice triage staff, physician and practice management to determine if an accommodation can be made in order to provide the patient with an earlier appointment. Follow-up with the patient or referring physician's office as appropriate.
- Coordinates and schedules all appointments with interpreter services as necessary.
- As necessary, conferences in appropriate interpreter services or language line representatives into patient phone calls to provide high quality service to patients who require interpreting services
Answer incoming telephone lines in a timely fashion, using the Practice standard greeting and other telephone etiquette. Adhere to other relevant organizational and departmental service standards related to telephone access in order to ensure that patients, referring physicians, and other customers can easily access the Practice by telephone. Respond to all electronic communication from patients and regarding patient care in accordance with practice's communication standards.
- Cancel and reschedule appointments as requested. When canceling an appointment, treat patients kindly and professionally. Inquire as to whether/when they would like to reschedule the appointment.
- Optimize access and satisfaction by maintaining and working the appointment wait list.
- Work the physician's cancellation (reschedule) list as required. Ensure that any outbound calls or communication are clearly documented on the patient's appointment record.
- Make appointment reminder calls in accordance with departmental protocols.
- Ensure that patients' questions are appropriately answered and/or that appropriate follow-up is provided.
Have knowledge of and be able to discuss with patients the billing practice associated with department of Dermatology appointments and procedures.
- Adhere to Practice standards related to amount of time logged in as an agent and amount of time available for taking calls
- Adhere to relevant standards related to placing calls on hold and transferring calls.
- Adhere to relevant standards related to voicemail and the management of internal lines.
- Respond to telephone messages within established timeframes.
- Appropriately manage all calls, either by working with the customer or by referring the call to the appropriate party. For routine matters, respond directly to customer inquiries without referring the caller elsewhere. This includes responding to inquiries related to the availability of appointments, scheduled appointment dates and times, parking, directions, and general information about BWH, BWPO and the Practices within the Department of Dermatology
- Respond to all electronic communications from patients, staff members, physicians and outside referral sources in accordance with practice's communication standards. These communications include but are not limited to emails, patient portal messages and fax
Other duties and responsibilities as assigned by Practice Coordinator, Practice Manager or designee:
- Aware of department billing practices, including split billing practices
- Able to understand basic insurance operations, including knowledge of insurances contracted with BWH, circumstances in which referrals are required, and assessment of copays due at visits
- Able to understand and discuss frequently asked billing questions with patients, both over the phone and at the time of appointments.
- Able to help patients understand department billing practices and answer basic billing related questions. Connects patients with additional resources, including department revenue operations team, financial counseling services, managed care, and hospital billing department as needed.
- Educate patients about financial assistance options and resources when appropriate.
- Handling of all incoming faxes and distribution to appropriate staff
- Cross coverage for clinical administrative positions
Schedule requirements: Flexible Shift eligible. Alternate Work Schedule is not available for this position. This position requires a 40 hour/5 day work week (Monday - Friday). Hours as needed by Department. Occasional overtime may be required.Qualifications
• High school diploma or GED required; post-high school education preferred.
• Minimum one year of applicable work experience required.
• Additional training in office systems preferred. SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
Technical skills required:
• Knowledge of practice operations and standards.
• Understanding of procedures including filing, copying, scanning, printing, and faxing.
• Ability to use phone system (answer and screen calls, put on hold), answer routine questions, and give routine information.
• Ability to interpret information as appropriate, answer routine questions in the most professional manner, and communicate in a professional, courteous, clear, and concise manner.
• Ability to manage work processes in a neat and orderly way and to sort and alphabetize.
• Ability to manage multiple tasks effectively, follow established protocols, and work within systems.
• Ability to correspond and communicate with others clearly and effectively in writing (via e-mail, memo, or interoffice note) and to take complete and accurate messages.
• Ability to type and enter data at an entry level. Entry level understanding of applicable systems.
• Understanding of the appropriate use and importance of related forms.
• Basic understanding and use of medical terminology.
• Basic comprehension of insurance types and referral process.
• Basic comprehension of registration and fiscal information.
• Knowledgeable and compliant with all hospital, State, and Federal requirements (where applicable to job performance), including policy and procedures with The Joint Commission and HIPAA. WORKING CONDITIONS:
Hospital based ambulatory practice. Normal patient environments where there are some exposures to communicable diseases, unpleasant odors, needle, and blood products.HOSPITAL WIDE RESPONSIBILITIES:
Works within legal, regulatory, accreditation and ethical practice standards relevant to the position and as established by BWH/Partners; follows safe practices required for the position; complies with appropriate BWH and Partners policies and procedures; fulfills any training required by BWH and/or Partners, as appropriate; brings potential matters of non-compliance to the attention of the supervisor or other appropriate hospital staff.EEO Statement
Brigham and Women's Hospital is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, national origin, sexual orientation, protected veteran status, or on the basis of disability.