About Wilmington Health
Since 1971, Wilmington Health has been committed to the care and health of our community in Wilmington as well as all of Southeastern North Carolina. Wilmington Health is structured as a multi-specialty medical practice with primary care providers integrated into the system. In this way, Wilmington Health is able to provide a comprehensive and coordinated approach to the care of all our patients. Wilmington Health is committed to using collaborative, evidence-based medicine in providing the highest quality of care to the patients we serve.
Purpose:
The Appointment Scheduling Specialist is responsible for managing patient appointments, providing outstanding customer service, and ensuring efficient coordination of medical services. This role includes scheduling appointments, verifying insurance information, handling patient inquiries, and ensuring accurate entry of patient details. The Specialist plays a crucial role in maintaining smooth communication between patients, providers, and office staff.
Essential Duties/Responsibilities:
Phone Management
- Handle all incoming calls from patients to schedule appointments for medical care, and screening and diagnostic testing.
- Provide exceptional customer service by addressing patient inquiries, concerns, and requests with empathy and professionalism.
Appointment Scheduling
- Schedule, reschedule, confirm, or cancel patient appointments as requested.
- Make new patient appointments, ensuring that all demographic and insurance information is entered accurately into the system.
- Communicate effectively with patients to confirm appointments, provide necessary pre-appointment instructions, and answer any questions.
- Utilize scheduling software to coordinate and organize patient appointments efficiently.
- Work closely with healthcare providers to accommodate urgent and specialized appointment requests.
Patient Communication
- Provide appointment reminders, including office locations, required paperwork (mailed or available on the website), and any balance due on the account.
- Explain relevant health plan information and assist patients in understanding their coverage.
- Communicate promptly with patients regarding any schedule changes, cancellations, or adjustments.
Data Entry and Insurance Verification
- Enter and update patient demographic information, including policyholder details and insurance information.
- Verify insurance coverage, including Tricare and Medicaid, ensuring accurate information is reflected in the system.
Rescheduling and Provider Coordination
- Reschedule appointments when providers are out of the office and communicate changes to patients, collaborating with office staff when necessary.
- Communicate schedule changes or adjustments to relevant staff members promptly.
Financial Responsibilities
- Collect copays for same-day virtual visits and ensure proper documentation is maintained.
Other Duties:
- Other duties as assigned.
HIPAA, Security, and Privacy Requirements:
- HIPAA Compliance
- Ensure all Protected Health Information (PHI) is handled in accordance with the Health Insurance Portability and Accountability Act (HIPAA).
- Maintain confidentiality of patient records, medical history, billing information, and other sensitive data.
- Access, use, and share PHI only as necessary for billing and claims processing purposes.
- Data Security
- Follow organizational security protocols to safeguard electronic and paper-based patient information.
- Ensure secure storage and transmission of PHI, including the use of encrypted systems or platforms approved by the organization.
- Adhere to password management policies, two-factor authentication, and other security measures to protect access to the Practice Management and billing systems.
- Privacy Protection
- Maintain a strict “need to know” basis for accessing patient information.
- Follow procedures to minimize unauthorized access to patient records, whether physically (in-office) or digitally (online systems).
- Promptly report any security breaches or unauthorized access incidents to the appropriate department or compliance officer.
- Documentation and Auditing
- Accurately document all actions involving patient information to ensure a clear audit trail, including billing, claims processing, and collections activities.
- Participate in regular audits and reviews of billing practices to verify compliance with HIPAA and security regulations.
- Training and Continuing Education
- Complete required HIPAA and security training as mandated by the organization.
- Stay updated on changes in healthcare privacy laws, HIPAA regulations, and organizational policies regarding patient data security.
- Incident Reporting
- Recognize and report any potential privacy or security violations, including unauthorized access to PHI, data breaches, or suspicious activities, following the organization’s incident reporting procedures.
Qualifications:
- Education: High school diploma or equivalent.
Required:
- Previous experience in a medical office or similar role, particularly in appointment scheduling and patient interaction.
- Strong communication skills, with a focus on empathy and active listening.
- Proficient computer skills, including experience with scheduling software and electronic health record (EHR) systems.
- Ability to multitask and prioritize in a fast-paced environment.
- Attentional to detail and accuracy in data entry.
- Excellent communication and interpersonal skills.
- Ability to manage high volumes of calls and multitask in a fast-paced environment.
- Friendly and professional demeanor.
- Ability to handle patient inquiries with empathy and resolve issues in a timely manner.
- Adaptable to changes in scheduling and able to work under pressure.
Preferred:
- Familiarity with insurance plans such as Tricare and Medicaid.
ADA Physical Demands:
Rarely (Less than .5 hrs/day) Occasionally (0.6 – 2.5 hrs/day) Frequently (2.6 – 5.5 hrs/day) Continuously (5.6 – 8.0 hrs/day)
Physical Demand
Required?
Frequency
Standing
Occasionally
Sitting
Continuously
Walking
Rarely
Kneeling/Crouching
Lifting
General Competencies
To perform the job successfully, an individual should demonstrate the following competencies:
- Customer Service
- Professionalism/Integrity/Responsibility
- Teamwork/Process Focus
- Dependability/Punctuality
- Interpersonal Relationships/Communication
- Judgment/Decision Making/Problem Solving
- Quality/Quantity
- Initiative
- Safety and Housekeeping
- Organizational Skills/Time Management
- Quality Management
Skills Required
- High school diploma or equivalent
- Previous experience in a medical office or similar role, particularly appointment scheduling and patient interaction
- Strong communication skills with empathy and active listening
- Proficient computer skills, including scheduling software and electronic health record systems
- Ability to multitask and prioritize in a fast-paced environment
- Attention to detail and accuracy in data entry
- Excellent communication and interpersonal skills
- Ability to manage high volumes of calls and multitask
- Friendly and professional demeanor
- Ability to handle patient inquiries empathetically and resolve issues promptly
- Adaptability to scheduling changes and ability to work under pressure
- Familiarity with insurance plans such as TRICARE and Medicaid
What We Do
Since 1971, Wilmington Health has been committed to the care and health of our community in Wilmington as well as all of Southeastern North Carolina. Wilmington Health is structured as a multi-specialty clinic with primary care providers integrated into the system. In this way, Wilmington Health is able to provide a comprehensive and coordinated approach to the care of all our patients. In 2013, Wilmington Health was named a 2013 Acclaim Award Honoree by the American Medical Group Association (AMGA). The prestigious honor is awarded annually to only three national healthcare organizations. Previous esteemed Acclaim Award Honorees include Mayo Clinic Health System, Johns Hopkins Medicine, and The Cleveland Clinic. Wilmington Health’s drive to become a High Performance Health System (HPHS) began over five years ago by taking a programmatic approach involving a three part system of change including direction setting by our leadership, process improvement at the ground level, and a redesign of the most elemental processes throughout the organization. A priority was given to paying careful attention to metrics, analysis, and critical assessment of each innovation and how these changes may affect the total cost of care. Only by understanding each of these aspects at work, was the organization able to pragmatically and intelligently design a future approach to the provision of healthcare. Additionally, Wilmington Health leadership began to put greater focus on creating a culture of change within the organization, understanding that this is the most powerful tool in any transformative process. Included were new and improved support systems for staff and providers and development of an inspirational approach to leading the entire team to provide patient-centered healthcare. July 2012, Wilmington Health partnered with Blue Cross and Blue Shield of North Carolina to form an ACO agreement. This was the first insurer-provider Accountable Care Organization in the region.






