Naples Comprehensive Health (NCH)
Naples Comprehensive Health (NCH)
ABOUT NCH
NCH is an independent, locally governed non-profit delivering premier comprehensive care. Our healthcare system is comprised of two hospitals, an alliance of 700+ physicians, and medical facilities in dozens of locations throughout Southwest Florida that offer nationally recognized, quality health care.
NCH is transforming into an Advanced Community Healthcare System(TM) and we’re proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan.
Join our mission to help everyone live a longer, happier, healthier life. We are committed to care and believe there's always more at NCH – for you and every person we serve together. Visit nchjobs.org to learn more.
JOB SUMMARY
The Patient Service Representative Wound Care is responsible for the smooth and effective operation of the front desk of the Wound Care Center to include patient scheduling, admitting and registration, insurance pre-certification and authorization, charge entry and tracking, and reviewing the dictation and documentation performed by the clinical staff. Documents referrals and communicates with physicians, home health and extended care facilities as required. Tracks changes and revenue generated by the Center.
ESSENTIAL DUTIES AND RESPONSIBILITIES
– Other duties may be assigned.
· Answer the phone promptly in a positive and professional matter.
· Schedules patient appointments. Obtains all information required to register a patient during the initial appointment scheduling call.
· Greet patient appointments. Obtains all information required to register a patient during the initial appointment scheduling call.
· Maintains the new patient members and attendants per NCH’s Standard of Behavior.
· Maintains the new patient scheduling system based on referral source preference, medical staff bylaws restrictions and panel physician preference, specialty and rotation status.
· Maintains the list of all the insurance plans in which the Hospital and the panel physicians participate. Obtains insurance pre-certification and authorizations as needed and furnishes to each of the panel physicians. Obtains prior approval if required. Prior to last approved visit, obtain approval from the payor for any additional visits.
· Prepares charts, assembles charts for patients scheduled the following day. Assures that patient test results that are not available in PowerChart are available to the physician.
· Coordinates and performs daily charge entry per Hospital policy. Reconciles charges daily by comparing the superbill and dictation to the daily charge entry report. Ensures that the hospital postings of all adjustments based on insurance type and date of service are accurate.
· Makes referrals to ancillary services, per physician orders. Keeps track of all inpatient and ancillary charges on a daily basis.
· Reconciles weekly and monthly end statistics with Director and Clinical Manager.
· Updates the charge master and the super bill when appropriate.
· Establishes and maintains a system to ensure that all dictated progress notes have physician signatures prior to being placed in the chart. Sends copy of medical record face sheet, progress notes and superbill to the physician’s office manager as needed.
· Reviews physician dictation of E & M visits and procedure notes for quality assurance and physician education purposes.
· Ensures that charts are completed in a timely matter.
EDUCATION, EXPERIENCE AND QUALIFICATIONS
· Minimum of High School or GED required.
· Minimum of 1 year of experience preferred in a clerical or administrative position.
· Intermediate computer knowledge: Uses Microsoft Word, Excel, Outlook, and Windows