Patient Service Supervisor

General Summary of Position
The individual in this position is responsible for coordinating in conjunction with the Patient Services Manager or Department Administrator all the functions and activities related to patient access in the department including but not limited to front end customer service accurate patient registration in the approved organization electronic scheduling and billing systems on-site insurance verification and financial counseling accurate Time-of-Service (TOS) payment collections and the balancing of all TOS payments using the approved organization electronic scheduling and billing system Front Desk Module. The person in this position supervises and directs the maintenance and ongoing monitoring of the patient health record in department. The person in this position is responsible for organizing training and supervising the activities of personnel engaged in Patient Service activities. The person in this position creates and edits master schedules and works closely with the Patient Processing Manager to identify patient service issues and ensure continuity of services to patients and providers. These functions are performed in accordance with Georgetown University Hospital's (GUH) philosophy policies procedures and standards.

Primary Duties and Responsibilities

• Registration Process - Supervises the entire patient registration process including staff adherence with all established policies and procedures related to querying the Enterprise Access Directory (EAD) and obtaining complete demographic and insurance information for each patient appointment.
• Participates in all personnel activities for registration staff including interviews orientation and training scheduling work sampling quality assurance and performance management. Regularly evaluates / mentors staff and counsels when appropriate. Ensures staffing is appropriate for clinic demand and makes recommendation to supervisor for staffing modifications as necessary.
• Scheduling Process - Supervises the entire patient appointment scheduling process including staff adherence with all established policies and procedures related to determining and accurately documenting the appropriate appointment type provider referral and/or authorization requirements procedure orders and other appointment specific requirements
• . Supervises the scheduling of surgical cases procedures and admissions for the department including staff adherence with GUH procedures and appropriate communication of GUH facilities policies and instructions to patients and families. Supervises and directs implementation and maintenance of the approved organization electronic scheduling and billing system patient scheduler system including triaging referrals and/or orders to the appropriate physician for care
• . Performs or insures the performance of all master scheduling functions including development and maintenance of master schedules. Performs or insures the performance of daily scheduling edits as necessitated by provider schedule changes.
• Patient Arrival / Check-in & Check-out Processes - Supervises the patient check-in and check-out process for department including patient reception validation of patient identity scanning of patient documents to the appropriate system resolution of all alerts for missing or inaccurate information prior to patient arrival insurance verification collection and electronic posting of time of service (TOS) payments appropriate and timely statusing of all appointments collection and review of all encounter forms daily deposit of TOS payments and preparation of charge batches.
• Supervises daily batching process including encounter form completion and reconciliation to optimize charge capture and reimbursement. Reports to the Patient Services Manager and/or Administrator on daily activity and process improvement initiatives.
• Ensures compliance with all applicable Georgetown Physicians Group (GPG) GUH department and internal audit policies and procedures. Ensures staff adherence to accurately review follow up and complete the approved organization electronic scheduling and billing system standard and custom reports including past pending missing charge charge lag and rejection reports. Recommends and implements corrective actions as appropriate. Addresses physician/patient issues and inquiries promptly and appropriately.
• Provides resolution and follow up as necessary including written and verbal correspondence. Acts as liaison to the Physicians' Unified Billing Services (PUBS) and the Patient Financial Clearance Unit (PFCU) for patient account and provider enrollment issues and the Managed Care Department for insurance plan matters.
• Referrals Pre-certification and Authorization Process - Supervises the referral pre-certification and authorization process for department including staff adherence to all GPG GUH and Managed Care Department requirements and contracts to ensure all patient appointments have required approvals in advance of the appointment.
• Determines in conjunction with the provider if an appointment can be rescheduled if there is a missing referral pre-certification or authorization. Supervises communications with insurance companies patients and providers regarding eligibility verification benefits and deductible status and authorizations for office-based and Hospital services procedures and admissions.
• Ensures coordination with the PFCU in obtaining any missing information for patient appointments. Ensures that eligibility and applicable authorizations are obtained prior to services being rendered for any and all accounts not previously verified through the PFCU. Supervises documentation of referrals and authorizations in the approved organization electronic scheduling and billing systems. Ensures staff adherence to correct use of all applicable data fields in the Open Referral Module and on the Appointment Data Form (ADF).
• Provides training and education of staff on managed care contracts and processes system utilization of the approved organization electronic scheduling and billing system Joint Commission (JC) standards and Health Insurance Portability and Accountability Act (HIPAA) privacy guidelines and compliance issues.
• Patient Health Records - Responsible for ensuring staff adherence to GPG GUH and departmental policies and procedures for access to patient Medical Records / Electronic Health Records (MR/EHR). Supervises Scheduler Front Desk Administrative Support and Department Pre-certification / Authorization staff utilization of MR / EHR ensuring protocols are followed.
• Monitors staff phone notes prescription requests and other EHR updates for timeliness and appropriateness. Participates in internal chart audits and monitoring of chart activity including complete patient intakes/dictations problem lists and disposition notes. Coordinates storage of files and maintains database for inactive patient charts.
• Oversees the technology initiatives including EHR implementation projects and ongoing performance enhancements. Audits staff productivity and utilization of EHR and billing system to include indexing scanning phone notes files in error and other appropriate measures of staff productivity.
• Patient Satisfaction - Collaborates with health care team members including physicians social workers residents and other clinicians as well as the Department Administrator and Patient Services Manager to identify barriers to efficient quality service. Participates in the development implementation and evaluation of measures to enhance services provided in the clinic.
• Assists with planning developing and implementing new policies and procedures for outpatient clinic. Responds to patient complaints and facilitates resolution of service breakdowns. Monitors patient satisfaction results reviews with staff and collaborates in process improvements.
• Performs other duties and responsibilities that are appropriate to the position and area. The above responsibilities are a general description of the level and nature of the work assigned to this classification and are not to be considered as all inclusive.

Minimal Qualifications
Education

• Associate's degree Two years college preferred and
• Bachelor's degree preferred

Experience

• 4 years experience in a customer service environment including previous experience with an electronic health record system desired especially GE centricity EH or Aria required
• Medical/clinical office experience including previous experience with computerized registration systems and supervisory experience preferred

Knowledge Skills and Abilities

• Excellent interpersonal communication and customer service skills and good telephone etiquette.
• Knowledge of medical terminology HMO/PPO insurances.
• Effective oral and written communication skills.
• Ability to deal effectively and professionally with a variety of different individuals.
• Ability to perform in a high pressure environment and appropriately motivate staff.
• Ability to organize and prioritize work.