Operations Specialist-Cardiology (Finance)

Nemours is seeking an Operations Specialist in our Cardiology Department.

This position is primarily responsible for scheduling new patient referrals for the Cardiology division, scheduling follow up appointments, confirming Appointments, ensuring provider schedules are optimized. This position processes clinic cancellation request and rescheduling of impacted patients due to clinic closures. This position serves as a liaison between the Cardiology division and other areas within Nemours, provides exemplary customer service for internal and external customers on behalf of the Cardiology division and is responsible for answering all inbound telephone calls.

Essential Functions:

New Patient Referrals:

Processes New Patient Referrals on behalf of the Cardiology division by contacting parents/guardians within 24 hours of receipt of referral.

Registers patients according to reliable methods, validates demographics and ensures primary insurance is captured.

Ensures authorization for services is received and contacts primary care physician to obtain authorization when not available.

Updates status of each referral in the New Patient Work Queue and follows reliable methods to ensure accurate data is captured.

Reports defined metrics to Operations Manager and Service Line Administrator.

Collaborates with clinical team to ensure referrals are triaged appropriately, patients are seen in a timely manner and in the appropriate location closest to their home.

Demonstrates an understand of I Guide and participating insurance plans.

Keeps abreast of insurance requirements to minimize denials.

Scheduling Follow up Patients.

Appointment Confirmation:

Confirms Appointments by following the established reliable method for Cardiology.

Reports defined metrics to Operations Manager and Services Line Administrator.

Cancels/reschedules patients' appointments when unable to attend.

Optimizes Provider Schedules:

Scans provider schedules daily and backfills appointments to ensure provider schedules are > 90% scheduled on the day of service.

When necessary, adjusts patient appointments to ensure enough time is available and gaps in provider schedules are minimizes.

Scheduling Templates:

Possesses a working knowledge of Cadence templates, provider patterns, and visit types.

Clinic Cancellation & Rescheduling:

Processes all Clinic Cancellation and Rescheduling requests on behalf of the Cardiology division within 8 business hours or less of receipt.

Reschedules patients impacted by cancellation.

Customer Service:

Provides customer service in an exemplarily for both internal and external customers.

Communicates in a timely manner via electronic communication (Outlook messages, Epic In basket messages, and Epic Telephone Encounters).

Additional miscellaneous duties and responsibilities, as may be assigned from time to time by employee's supervisor.

Requirements:

Medical office and/or call center experience preferred

Associate degree preferred

Customer service experience required.