Position Class Code/Title: A3019 / Ambulatory Patient Services Coordinator
BEST CONSIDERATION DATE: OPEN UNTIL FILLED
UNM Medical Group, Inc. (UNMMG) is the practice plan organization for physicians and other medical providers associated with the UNM Health Sciences Center. UNM Medical Group, Inc. is a New Mexico non-profit corporation and is an equal opportunity employer. UNMMG offers a competitive salary and an attractive benefit package which includes medical, dental, vision, and life insurance as well as tuition assistance, paid leave and 403b retirement for benefits eligible employees.
UNMMG is currently seeking an Ambulatory Patient Services Coordinator who will work in the Patient Financial Services Department of the UNM Cancer Center. This individual will interview patients and complete the application process for state/govenment programs; interview and approve patients for UNM Hospital charity and discount programs; reconcile and complete cash reconciliation reports; balance and post payments; and handle patient inquiries, complaints and customer service issues by phone, in person or via e-mail and resolve the issue.
The following statements are intended to describe, in broad terms, the general functions and responsibility levels characteristic of positions assigned to this classification. They should not be viewed as an exhaustive list of the specific duties and prerequisites applicable to individual positions that have been so classified.
Under limited supervision, performs a wide variety of administrative support functions at assigned UNMMG Ambulatory Clinic including but not limited direct service to patients either by phone or in person by scheduling appointments, receptionist duties, verifying demographic and insurance information, obtaining referral and prior authorizations with insurance carriers. Assist with concerns and complaints and serving as a liaison as needed with physicians, other providers and insurance companies.
DUTIES AND RESPONSIBILITIES
- RECEPTION: Responsible for clinic receptionist duties including but not limited to: answer incoming phones, patient check in/out, coordinate and facilitate accurate patient appointment scheduling through electronic and/or manual systems, schedule follow-up appointments as ordered by providers, update and ensure accurate patient schedules and appointments in UNMMG computer systems.
- REGISTRATION: Responsible for registration duties including but not limited to: obtaining copy of insurance card, verifying accuracy of patient demographics and insurance information; updating and ensuring accurate information into UNMMG computer systems.
- FINANCIAL / CASH MANAGEMENT: Responsible for collecting co-pays, collecting upfront payments as well as self-pay down payments; generating patient receipts; referral of patients to financial counseling for funding options, if necessary. Responsible for daily cash reconciliation of cash collections and receipts; following UNMMG established cash management policies and procedures.
- BILLING: Responsible for generating charge document and other billing paperwork at time of patient’s clinic visit to ensure proper billing information is obtained and documented including but not limited to completion of paperwork by provider, written documentation on clinic log, DX and CPT code selection by provider on charge document, prompt submission to UNMMG centralized charge entry.
- PRIOR AUTHORIZATION: Responsible for coordinating and processing all referrals and prior authorizations. Interface with insurance companies to verify coverage and obtain prior authorizations; may coordinate multiple authorizations and coverage; compiles medical documentation necessary to ensure prior authorization is obtained; updates computer systems to ensure final prior authorization is documented in UNMMG computer systems.
- Maintain ongoing communications and dialog with the centralized UNMMG Practice Coordinator to address staffing issues, ongoing training and support as well as to address problems or issues related to clinic front-end processes and operations.
- Maintains record keeping and filing systems; gathers, enters and updates data as required.
- Serves as backup support for other administrative personnel as required; cross trains with other personnel for all administrative, customer service and clerical functions.
- Performs miscellaneous job-related duties as assigned.
MINIMUM JOB REQUIREMENTS
High school diploma or GED with at least 2 years of directly related experience acquired working in a medical environment. Verification of education and licensure (if applicable) will be required if selected for hire.
KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
- Strong written and verbal communication skills.
- Records maintenance skills.
- Skill in the use of computers and related software applications; ability to learn new software.
- Demonstrated ability to multi-task and prioritize work.
- Knowledge of medical records, billing and/or coding
- Knowledge of HMO, PPO, Medicare, Medicaid, insurance plans
- Demonstrated ability to work with private data and maintain confidentiality.
CONDITIONS OF EMPLOYMENT
- Must be employment eligible as verified by the U.S. Dept. of Health and Human Services Office of Inspector General (OIG) and the Government Services Administration (GSA).
- Must pass a pre-employment criminal background check.
- Fingerprinting, and subsequent clearance, is required.
- Must provide proof of varicella & MMR immunity or obtain vaccinations within 90 days of employment.
- Must obtain annual influenza vaccination.
- If this position is assigned to a clinical area, successful candidate will be required to complete a pre-placement medical evaluation/health screen. Required N-95 mask fitting, testing, vaccinations to include annual TST and Hepatitis will be determined based on location and nature of position.
WORKING CONDITIONS AND PHYSICAL EFFORT
- Work is performed in an interior medical/clinical environment.
- No or very limited exposure to physical risk.
- Sedentary Work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body.
- Work involves sitting most of the time, but may involve walking or standing for brief periods of time. Walking and standing are required only occasionally and all other sedentary criteria are met.
- No or very limited physical effort required.