Outpatient Access Rep III
Rochester, NY
GENERAL PURPOSE:
Coordinates activities of Outpatient Access Specialists. Acts as a resource to staff performing those functions in a clinic setting. Monitors and assures that all functions are completed in an accurate, efficient, and customer friendly manner. Coordinates all staff training activities. Assists clinic supervisor or manager through various aspects of operational support which may include assisting with lead duties such as personnel related matters, including performance evaluations, and developing plans for improvement in staff member's completion of assigned activities. Other duties may include being the front office eRecord superuser, assist with workflow design and implementation and serve as the front office expert supporting referral coordination, prior authorizations as well as be assigned as main provider support. The Outpatient Access Lead/Expert will be responsible for monitoring own performance on assigned tasks; is self-directed. Expert at making complex decisions independently and assists staff in complex decision making and adaptation to technology and systems used. Trains and coordinates the assignment and duties of Outpatient Access Specialists and those of less experienced support staff. Performs at a fully meets and often exceeds or consistently exceeds level.
JOB DUTIES AND RESPONSIBILITIES:
Performs duties of Outpatient Access Specialists as required by departmental needs. Sets the standard for customer service, accuracy, and efficiency in the Outpatient Access work areas.
May take on one or more of these specialized functions, as assigned:
Human Resource duties assisting the Clinic/Practice Manager such as personnel-related matters: Schedules staff work time, verifies time worked for supervisor in management of HRMS, and handles sick calls and vacation coverage needs. Provides input to supervisor on staff performance for evaluations and/or performance reviews. Works with supervisor to assure that all clerical functions are completed by available staff, assigns staff to special projects as needed. Acts as area authority in absence of supervisor.
Prior Authorizations: Prepares and provides multiple, complex details and facts to insurance carrier or worker's compensation carrier to obtain prior authorizations for both standard and complex imaging, or non-invasive procedures. Uses independent judgement to examine research and assemble necessary patient information via the scheduling system and multiple areas of the electronic medical record. Decides based on previous authorization approvals and denial experience, the relevant information to be included in the request.
Referral Coordination: Manages in-basket and referral work queue processing. Assembles from multiple tabs within the electronic medical record, the necessary details to identify what referral is needed. Determines if preliminary testing (i.e. Imaging) is needed based on office practices and procedures and is responsible for explaining to patient, assisting with scheduling and for completeness prior to office visit. Gathers documents as requested. Completes the referral request in the electronic medical record system once the patient has been seen by entering a new status as closed.
Direct Provider Support: Works one-to-one with assigned provider or multiple providers. Manages that providers schedule including template management and patient appointment scheduling. Oversees provider In- Basket to send messages and reminders for labs, etc. Address post visit items such as paperwork including form completion, letter templates and obtaining medical records, etc.
Coordination of operational activities: Identifies, implements and monitors operational changes to improve clinic functioning in conjunction with supervisor and other clinic staff. Updates and creates new policies and procedures. Incorporates new functions into the role of the Outpatient Access staff as needed.
Training: Coordinates all activities around staff training both internal and external to department. Once a staff member has been hired, schedules training through education services and eRecord. Creates schedule for new staff to learn clinic functions; monitors staff compliance with in-services/competency achievement. Develops programs of further education for staff. Works with supervisor to enhance education and interdisciplinary work on the unit.
Financial account management: On a daily basis reviews Dashboard for front end staff compliance to enterprise metrics. Where appropriate, follows-up with providers to reconcile discrepancies, and provides recommendations to supervisor for updates to workflows.
Template Management: Works with faculty practice and clinic representatives to maintain clinic schedules, instructs appointment scheduling staff regarding schedule changes, and pro-actively reviews future schedules to identify problems. Reviews management reports and actual schedules and reports to supervisor trends affecting the schedules and recommends changes to improve patient flow.
Patient Experience and Employee Engagement: Role models excellent customer service to patients and their families, providers and staff. Serves as a focal point for handling complaints, initiates service recovery activities, and serves as front-line trouble shooter and problem solver.
Partnering with the Clinic/Practice Manager implements activities with Outpatient Access staff that will improve the office culture and employee engagement.
Performs other duties as required, including attendance at Ambulatory Manager meeting or eRecord superuser meetings, working on special projects for Ambulatory Care, and working with faculty practices or other providers on special projects and reviewing workflows. Interfaces with leaders from the registration insurance mgmt. dept., enterprise training, patient financial services office and others as required of role.
QUALIFICATIONS:
High School Diploma required.
2 years of experience in an administrative capacity or customer service field required or an equivalent combination of education and experience.
Medical terminology experience preferred as well as expert knowledge of referral coordination, prior authorization and/or a demonstrated ability to train.
Demonstrated customer relations skills preferred.
The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.
How To Apply
All applicants must apply online.
EOE Minorities/Females/Protected Veterans/Disabled
Pay Range
Pay Range: $18.16 - $24.52 Hourly
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.
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