Outpatient Consultation Representative - Temporary - Outpatient Scheduling Department

Outpatient Consultation Representative - Temporary - Outpatient Scheduling Department

Position : Outpatient Consult Representative Temporary - Outpatient Scheduling Department

Kern Medical strives to recruit the highest quality candidates, resulting in a high performance workforce that consistently delivers quality patient care.

Temporary / Extra-help employment has a limited term (up to 9 months). Health Benefits coverage may be offered.

Job Description

Under supervision, submits required necessary documentation to insurance companies in order to obtain required prior authorization for patient care and / or treatment in addition to performing basic registration functions for the capture of pertinent demographic and insurance / payer information as well as scheduling activities, which may include : basic patient registration knowledge in order to effectively schedule appointments which will result in billable charges, collecting and entering accurate patient demographic information, selecting correct patient account information, validating necessity of authorization(s) for specific appointment types being booked and scheduled.

Compensation : The estimated pay for this position is $21.756 to $26.7575 per hour. This reflects only a portion of the total compensation package for this position. Additional compensation may be available for this role through differentials, incentives, and bonuses.

Distinguishing Characteristics : Incumbents have hospital / healthcare knowledge or experience, and are expected to gain specific knowledge of the importance of patient and insurance demographic information and the availability of payment options for patients requiring a referral to a financial counselor. Outpatient Consult Representatives will be responsible for prioritizing notifications received for pending consults, processing consults timely, ensuring that patient insurance information is accurate and that authorizations are in line with coordinated benefits, as well as utilizing all resources available to obtain swift approvals to ensure patient safety and continuity of care. Outpatient Consult Representatives will additionally be responsible for answering phones, directing patient calls to the appropriate departments when necessary and scheduling appointments for multiple different physicians, providers, specialties, clinics, and locations.

Essential Functions :

• Submits necessary documentation to insurance companies in order to obtain required prior authorization for patient care and / or treatment.
• Tracks and follows up on outstanding requests for authorization.
• Answers patient phone calls, reviews process, and schedules appointments for exam or follow-up.
• Enters all patient demographic information into electronic patient record system; uses other department applications for eligibility and authorization.
• Screens referrals and informs referring physician offices, patients and their families about hospital policies and procedures regarding method of payment sources for services rendered.
• Documents funding information from patients and provides information on available funding resources; refers patients to financial counselors when funding is not in place.
• Uses payer resources and websites to explore and assess eligibility.
• Assist with training of staff members.
• Works in collaboration with outpatient scheduling and registration to identify and resolve issues and / or barriers.
• Submits and responds to requests for information and inquiries related to outpatient authorization / scheduling processes, policies, and / or other related information; researches and resolves customer problems.

Other Functions :

Employment Standards :

Knowledge of :

Ability to :

Supplemental :

All Kern Medical employees are designated "Disaster Service Workers". In the event of a disaster or civil disorder, all Kern Medical employees are to remain at work or to report to work in a safe and practicable manner.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.