New Patient Referral & Authorization Coordinator, Cardiology Clinic, (Larkspur), Full Time, Days

Larkspur, CA

About MARINHEALTH a UCSF Affiliate:

MarinHealth Medical Network is a medical foundation representing the physicians, their care teams and office staff, who previously operated under Prima Medical Foundation or the Marin Healthcare District. With a network of clinics across many different medical specialties throughout Marin and Southern Sonoma County, MarinHealth Medical Network functions as an extended family of healthcare advocates who take pride in knowing that we aren't just making a living; we're making a positive impact on the health of our patients and their families. Come and join us in touching and transforming lives every day!

External hires are subject to a background check and pre-employment medical screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with federal, state and local laws. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classifications protected by federal, state & local laws.

GENERAL SUMMARY:

Schedules patient appointments according to guidelines for new patient referrals, re-call follow up, urgent same-day, and assigned “Task” requests. Works in collaboration with teams to monitor daily patient schedule. Required to manage schedules for multiple patient appointments and ensure physician availability and adequate exam time. Essential duties include but are not limited to: providing excellent patient service via phone and in office; making appointments for patients according to established protocols. When scheduling appointments, verifies patient demographics, insurance eligibility and benefits, and reason for visit are critical. Scheduler provides guidance to new and established patients regarding their upcoming visit. Instructs Patient to complete any necessary paperwork or pre-work. Explains policies and procedures for visit to all new and established (as needed) Patients. Provides payment explanations and expectations. Executes the process necessary to support referrals and office visit authorizations as required by the Patient’s insurance plan.

SCHEDULING RESPONSIBILITIES:

• New Patient Referrals, Fax, And Task
• Routine Re-Call (3, 6, 9, 12 Month)
• Same Day Urgent Appointments
• Monitor Scheduled Follow-Up Appointments
• Monitor Daily Add-On Appointments
• Concierge Scheduler as Appointed
• Back-Up Scheduler as Needed

NEW PATIENT REFERRALS:

• Maintains and completes daily Primary Care Physician and specialist physician’s referral appointments for Consultation
• Performs the Pre-Registration Orientation call to obtain Patient demographics, insurance information, explain policies, and answer Patient’s questions regarding services. Communicates financial policy and charge amounts
• Responsible for verifying Patient’s insurance coverage, eligibility, and benefits, including entering accurate information in All Scripts system, and providing Medical Records Department with print-out of insurance info
• Responsible for mailing “New Patient Package” to Patients scheduled for consultation & provides instructions to Patients on how to complete paperwork prior to appointment
• Responsible for obtaining New Patient referral authorizations from PCP or insurance plan as required
• Responsible to request and receive appropriate medical records from Referring Physician prior to appointment
• Tracking of no-show, cancelled, & missed New Patient appointments for immediate re-scheduling
• Maintains direct and frequent communication with teams
• ROUTINE RE-CALL (3, 6, 9, 12 month)
• Maintains monthly All Scripts Re-Call Report for Follow-up appointments
• Schedules Re-Call Follow-up appointments with Patient within 2 months of anniversary date (3,6,9,12 month)

Maintains updated Patient demographics, insurance coverage (eligibility & benefits):

• Responsible for obtaining office visit authorizations from PCP or insurance plan as required
• Responsible for scheduling Follow-up appointments as requested through All Scripts “My Task List”
• Reviews prior Progress Note for required Orders Before Follow-up appointment
• Responsible to Task and communicate needed Orders for Patient’s to complete before appointment date
• Tracking of no-show, cancelled, & missed Re-Call appointments for immediate re-scheduling
• Prioritizes “My Task List” on a daily basis for completion of all tasks by end of work week

SAME DAY URGENT APPOINTMENTS:

• Maintains direct communication with teams to ensure proper scheduling of “Same Day Urgent Appointment” for Patients
• Reviews daily ‘HOLD” appointments for each physician’s schedule, and provides this information to Staff as needed
• Communicates with Front Desk Scheduler(s) the Urgent and/or Add-on appointment(s) for the same day
• Requests RAFs or authorizations from insurance plans, if needed for office visit

MONITOR SCHEDULED FOLLOW-UP & DAILY ADD-ON APPOINTMENTS:

• Maintains direct communication with staff to ensure proper scheduling of weekly schedule
• 5 days prior to appointment dates reviews each physician’s schedule for patients not seen with 6+months & verifies insurance, obtains RAFs and authorizations for office visit as needed
• Communicates with PCP Office or Referring M.D. office as needed
• Verifies Patient’s Orders prior to appointment have been completed. Notifies Patient to complete orders as needed

MINIMUM QUALIFICATIONS:

• Minimum 3 years’ health care customer service experience.
• Must have good interpersonal skills.
• Must be able to communicate in a clear and positive manner, written, verbal and via multi-lined telephone system. Ability to read, understand, and follows oral and written instruction.
• Ability to identify problems and recommend solutions.
• Possess excellent typing/keyboarding skills; knowledge of computer systems and applications.

MarinHealth remains committed to the health and safety of our employees, patients, and the entire community. As such, MarinHealth requires employees to receive all required immunizations, including, MMR, flu (seasonal availability), and COVID-19 vaccine + booster, as a condition of employment and annually thereafter, as required. Any exemptions from these requirements may be granted for limited and specific situations.

Additional Information

• Department: 9010 - Network Cardiovascular
• Job Schedule: Full Time - 40 hours/week
• Job Shift: Day
• Hours per Two-Week Period: 80
• Shift Hours: 8 Hour Shift
• Job Number: MHMN20 - 644