Patient Referral Specialist

Company: City of Hope
Location: Irvine
Posted on: August 5, 2022

Job Description:

About City of HopeCity of Hope is an independent biomedical research and treatment organization for cancer, diabetes and other life-threatening diseases.Founded in 1913, City of Hope is a leader in bone marrow transplantation and immunotherapy such as CAR T cell therapy. City of Hope s translational research and personalized treatment protocols advance care throughout the world. Human synthetic insulin, monoclonal antibodies and numerous breakthrough cancer drugs are based on technology developed at the institution. AccessHope , a subsidiary launched in 2019 serves employers and their health care partners by providing access to City of Hope s specialized cancer expertise.A National Cancer Institute-designated comprehensive cancer center and a founding member of the National Comprehensive Cancer Network, City of Hope is ranked among the nation s "Best Hospitals" in cancer by U.S. News & World Report and received Magnet Recognition from the American Nurses Credentialing Center. Its main campus is located near Los Angeles, with additional locations throughout Southern California and in Arizona.City of Hope s commitment to Diversity, Equity and InclusionWe believe diversity, equity and inclusion is key in serving our mission to provide compassionate patient care, drive innovative discovery, and advance vital education focused on eliminating cancer and diabetes in all of our communities. Our commitment to Diversity, Equity and Inclusion ensures we bring the full range of skills, perspectives, cultural backgrounds and experiences to our work -- and that our teams align with the people we serve in order to build trust and understanding. We are dedicated to fostering a community that embraces diversity - in ideas, backgrounds and perspectives; this is reflected in our work and represented in our people.Position SummaryResponsible for the scheduling of patients for initial physician, administrative, and diagnostic testing appointment for New Patients as applicable. Creates corresponding visit in registration and ensures visit are linked with authorization and financial clearance completed. Provides patients with itinerary of future appointments and instruction as applicable. Ensures patient safety using positive patient identification protocol and obtains the appropriate consents. Assist patients with obtaining records, slides and other materials required for their initial visit. Provides accurate and timely communication with physicians and clinical staff with regard to records and imaging status. Provide clerical and scheduling support to the clinical staff.Key Responsibilities include:

• Screens telephone calls appropriately and expeditiously. Identifies and resolves issues at point of service and refers most difficult inquires to Patient Referral Services Clinical Nurse, or Departmental Management.
• Assists the Patient Referral Services Department in efficiently processing new patients and acquainting them with the City of Hope system.
• Creates appropriate outpatient visit for incoming new patients. Ensures all the appropriate information re: demographics, guarantor, diagnosis, and insurance is correct prior to the initial visit
• Processes and documents the updated verification of insurance using an on-line insurance verification system. Reports results of insurance verification to clinical and financial staff. Enters insurance into registration system.
• Maintains thorough knowledge of managed care and governmental payers.
• Insert the percentage and essential function
• Refers patients to financial counselors to resolve insurance or payments issues.
• Accepts, denies, and closes cases in registration system as directed by clinical staff
• Schedules patient appointments for clinic and /or diagnostic services as directed. Demonstrates an in-depth understanding of the flow of the patient scheduling process within the paper and electronic environments. As applicable, collaborates with other departments to schedule complex appointment types.
• Demonstrates accuracy and completeness in scheduling patient appointments. Escalates issues regarding scheduling in a timely manner to supervisor as applicable.
• Assures that the correct pre-registration visit encounter type is linked to the scheduled appointment.
• Ensures authorizations of services are entered into EPIC prior to confirmation call to patient
• Provides patients with appointment information and all necessary documents needed for new patient appointment
• Receives and manages phone calls from patients and departments regarding patient appointments.
• Contacts patients who fail to show for scheduled appointments. Reschedules appointments as directed and indicates reason for cancellation.
• Assures use of positive patient identification to assure accuracy
• Ensures Medicare MSP are completed as required
• Coordinates to ensure reports, diagnostic testing, biopsy slides, and any other pertinent material is received before initial visit. Documents and communicates receipt of materials on clinical forms and scheduling system
• Assists patient with the collection of outside medical records needed for their initial visit. Ensures that necessary data is received prior to the appointment. Follows up on missing materials as requested.
• Communicates and follows up with and notifies outside facilities of testing required before appointment at the medical center.
• Scans documents into patient electronic medical record. Performs a daily QC of scanned documents
• Verifies appointment schedules and directs or escorts patients as appropriate.
• Maintains a thorough knowledge of computer capabilities and functions in EPIC, Salesforce, and all necessary programs
• Maintains appropriate level of productivity for work performed.
• Maintains appropriate level of accuracy for work performed.
• Maintains departmental record and files for efficient operations, including online web applications. Assists with identification of trends and issues as it relates to marketing, public announcements, and factors affecting Patient Access.
• Assures workspace is neat and orderly
• Assures workspace is neat and orderly
• Properly documents all necessary notes and information into EPIC and Salesforce enabling easy transition for others covering the workspace.
• Maintains thorough knowledge of various sections within the department in order to provide assistance and back-up coverage when necessary.
• Investigates and/or ensures that questions and requests for information are responded to in a timely and professional manner. Receives, handles, and transfer phone calls and messages within the department promptly and courteously.
• Communicates and interprets patient and family needs and problems to the specialty team. Serves as liaison with hospital staff and personnel from other departments to coordinate the work of the department and its staff to facilitate providing care and services to patients.
• Assures that a positive service image is projected in all encounters with patients, visitors, and department staff. Greets patients and visitors, ascertains needs, and directs appropriately.
• Follows established City of Hope and department policies, procedures, objectives, performance improvement, attendance, safety, environmental, and infection control guidelines, including adherence to the workplace Code of Conduct and Compliance Plan. Practices a high level of integrity and honesty in maintaining confidentiality. 5
• Performs other related duties as assigned or requested. Basic education, experience and skills required for consideration:
  • High School or equivalent. Experience may substitute for minimum education requirements.
  • Three years medical office clerical or customer service experience. Certification or degree may substitute for minimum experience requirements.Preferred education experience and skills:
    • Medical office, telephone reception, computer scheduling, insurance verification and records procurement.
    • Demonstrated ability / experience working with healthcare professionals.
    • Medical terminology.Additional Information:
      • As a condition of employment, City of Hope requires staff to comply with all state and federal vaccination mandates.
      • There are 3 positions available.City of Hope is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, or status as a qualified individual with disability.

Keywords: City of Hope, Irvine , Patient Referral Specialist, Other , Irvine, California