PAS INTAKE SPEC
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POST DATE 8/23/2016
END DATE 11/5/2016
UT Soutwestern University Medical Center
JOB DESCRIPTIONFull/Part Time/PRN: Full-Time
This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information
EXPERIENCE AND EDUCATION
High school and three (3) to four (4) years of hospital admitting/ scheduling experience or equivalent.
Schedules patient care procedures accurately (procedure, exam, area or physician referral, location, time of procedure); balances exams with patient/customer time request and provider availability.
Interviews patient and/or physician's office to obtain medical history and patient demographic information and documents in EPIC and Siemens systems. Coordinates with physician's office and/or ancillary department regarding additional information needed to obtain pre-certification and insurance benefits. Maintains department productivity standards.
Pre-registers patient cases by entering complete and accurate information in Siemens system prior to patient's arrival. Identifies and verifies all essential information pertaining to intake, insurance verification/eligibility, and precertification on all applicable patient accounts. Revises information in computer systems as needed. Documents pertinent information and efforts in computer system based upon department documentation standards. Maintains department productivity standards.
Reschedules exams at patients' or departments' requests.
Initiates confirmation call back to patient to include: appointment reminder, location, time, prep instructions, and financial responsibility.
Ensures all exams are scheduled with proper clinical indicators and coding nomenclature.
Counsels offices and/or patients when an "out of network" situation becomes apparent or other potential payor technicalities arise. Coordinates with Financial Counselor to identify funding source and additional information needed to secure accurate third party billing and/or patient financial responsibility.
Coordinates as needed with other departments/ancillary areas for special needs or resources.
Demonstrates ongoing competency skills including age-specific compentencies, above level problem solving skills and decision- making abilities.
Performs other duties as assigned.
**Other Duties: Performs other duties as assigned.
SUMMARY OF PRIMARY DUTIES: The Intake Specialist analyzes, reviews funding/insurance information, and sets up patient billing records in the Hospital Billing System for scheduled patients. Applies knowledge of insurance contractual information to specific UTSW hospital-based scheduled services. Ensures that scheduled services and billing account set-up support proper and accurate billing.
1. Verifies insurance coverage and eligibility for all applicable scheduled services specific to the type of procedure and/or exam, and site of service. Evaluates physician referral and authorization requirements and takes appropriate steps to ensure requirements are met prior to date of procedure. Tracks cases to resolution and maintains productivity standards.
2. Interviews patient and/or contacts physician office staff to obtain necessary patient demographic information and documents information in EPIC ADT hospital billing system and appropriate ancillary systems. Coordinates with physician's office and/or ancillary department regarding any additional information needed on their part to obtain pre-certification and insurance benefits. Maintains department productivity standards.
3. Pre-Registers patient cases by entering complete and accurate information in EPIC ADT hospital billing system prior to the patient's arrival. Identifies/obtains/verifies all essential information pertaining to intake, insurance verification/eligibility and pre-certification on all applicable patients accounts with a 98% accuracy rate. Accurately revises information in computer systems as needed. Documents pertinent information and efforts in computer system based upon department documentation standards. Maintains department productivity standards.
4. Confirms accuracy of scheduled procedure/s and validates that authorization codes match the service delivered including following best practice to obtained revised authorization for codes that are changed and have been communicated timely through proper channels.
5. Contacts patient as appropriate to collect critical information and/or to advise of benefits information. Refers to financial counselor or other entity as appropriate and per customer satisfaction guidelines. Adheres to HIPAA guidelines when contacting patient.
To the extent provided by applicable law, no person shall be excluded from participation in, denied the benefits of, or be subject to discrimination under any program or activity sponsored or conducted by The University of Texas System or any of its component institutions, on the basis of race, color, national origin, religion, sex, sexual orientation, age, veteran status, or disability..