DIMENSIONS/SCOPE OF POSITION:
Makes and coordinates patient appointments across all Campbell Clinic Orthopaedics locations and providers to ensure full provider utilization and timely patient access. This role applies clinical triage judgment to place patients with the correct provider, owns insurance verification and prior authorization work to prevent scheduling and billing delays, and serves as a training resource for new hires.
ESSENTIAL DUTIES/RESPONSIBILITIES:
- Makes appointments for patients, reschedules and cancels through the patient portal, patient call, and outside referral software program
- Follows appointment guidelines to ensure proper scheduling
- Determines patient's clinical need to ensure proper scheduling
- Verifies patient insurance eligibility and benefits prior to scheduling; identifies visit types or plans requiring prior authorization or referral
- Initiates and tracks prior authorization requests, coordinating with insurance payers and clinical staff to resolve delays before the appointment date
- Accepts incoming patient phone calls and uses computer systems to schedule patients
- Triages patient needs for timeliness of appointments based upon pre-determined criteria
- Determines which physician to place patient with based upon pre-determined criteria
- Retrieves appointment requests from the patient portal and places outbound calls to patients to schedule appointments
- Monitors and replies promptly to patients' online portal messages
- Communicates and collaborates with physicians and medical staff to meet patient scheduling needs
- Trains and onboards new hires on scheduling protocols, triage criteria, insurance verification steps, and system use
- Meets daily and monthly call quota expectations as assigned by supervisor/manager
- Monitors and schedules patient referrals from hospitals and community medical partners
- Performs other related duties as assigned
SUPERVISORY RESPONSIBILITIES: Not Applicable
QUALIFICATIONS:
Education and/or Experience: High School Graduate or GED Required; 3 years of experience in a health business office setting required, including direct use of EMR/EHR systems and multi-line phone services, demonstrated experience with insurance verification and/or prior authorization processes, and experience training or onboarding new staff. Experience in a healthcare setting (physician's office, clinic or hospital) with knowledge of insurance, referral procedures, and healthcare terminology preferred.
Language Skills: Able to communicate effectively in the English language.
Mathematical Skills: Basic arithmetic skills are required.
Reasoning Ability: Identifies and resolves problems promptly.
Computer Skills: Must be computer literate. Basic computer skills required such as Word, Excel, Teams and Outlook. Must be able to type.
Other Skills and Abilities: Able to listen and respond well to questions and feedback.
POSITION QUALIFICATIONS
Competency Statement(s)/Mental Demands
- Active Listening - Ability to actively attend to, convey, and understand the comments and questions of others.
- Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
- Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.
- Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
- Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed
- Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
- Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
Campbell Clinic Benefit Summary:
Campbell Clinic offers a lucrative benefit package to support employees and their families.
- Medical / Dental / Vision Insurance
- HRA Option
- Flexible Spending Account
- Basic Life Insurance
- Voluntary Life Insurance Option
- Long-Term Disability
- Voluntary Short-Term Disability
- Accident Insurance
- Critical Illness Insurance
- 401(k) Plan Matching + Profit Sharing
- Employee Assistance Program
- Paid Time Off
- Paid Holidays
Equal Opportunity Employer/Veterans/Disabled
Skills Required
- High school diploma or GED
- At least 6 months of combined experience in a call center or high-volume scheduling department
- Experience using EMR/EHR systems
- Experience with multi-line phone services or customer service
- Healthcare setting experience, including knowledge of insurance, copay collection, referral procedures, and healthcare terminology
- Orthopedics experience
- Basic computer skills, including Microsoft Word, Microsoft Outlook, and typing
What We Do
Campbell Clinic is recognized as a national leader in sports medicine, pediatric orthopaedics, joint replacement, orthopaedic oncology, physical medicine and rehabilitation, and surgery of the hand, hip, foot, knee, shoulder and spine. We care for patients throughout their life, treating congenital issues as well as bone and joint problems affecting senior adults.
