GENERAL DESCRIPTION OF POSITION:

Performs a variety of Administrative functions for the Behavioral Wellness Department. Schedules appointments in Athena EMR for the Department, screens and processes referrals, obtains authorization from insurance companies, Medicare, Medicaid PCCM, assist in gathering data for reports needed, and types memos and correspondence. Calls and confirms appointment 24-48 hours in advance. Provides information to callers, disseminates information, and maintains a filing system.

Handles in person traffic and answering the telephone. Routes calls to appropriate department personnel. Performs all duties which involve interaction with patients and improve patient care outcomes. All interactions with patient will be in adherence to the PCMH principles, policies and procedures. Follows SC policies and procedures that are essential in carrying out the patient health care plan. Adhere to policies and procedures in conducting all clinical charges, payments, adjustments for proper billing and collections. The clerk will adhere to COVID protocols and state and county guidance. The clinician will have direct contact with the SC patients requiring the use of N95 and follow CDC guidelines for infection prevention and control. Will perform front desk clerical duties, including but not limited to greeting, registering, cleaning and sanitizing, which ensures the patient has a pleasant and satisfactory experience. Twenty percent (20%) occasional travel for meetings, to help Harlingen office, and training if needed

ESSENTIAL JOB FUNCTIONS: (with or without accommodations)

Patient communication: Greets, welcomes, and answers all the questions of the patients and family members accessing the Behavioral Wellness Clinic in a positive and professional manner. Assures that communication with the patient is culturally and linguistically appropriate. Processes incoming patient referrals for Behavioral Wellness services. Answers inbound calls regarding appointments, billing, collections, or general information. Communicates with patients and family member in both English and Spanish regarding appointments, charges, collections, and any other item pertaining to the delivery of services. If a phone inquiry is not appointment related, will answer questions in a positive and professional tome and will route the call to the appropriate personnel. When scheduling appointments, works with the patient to appropriately arrange appointments that meet the needs of the patient. Makes arrangements for interpretation services, if needed. Reinforces to patient, the importance of keeping appointments and communicating changes to those appointments, and provides appropriate instruction on preparation for the upcoming appointments. Communicates patient’s concerns or complaints to the Department supervisor. Processes mail, faxes, and inter-departmental mail.

Appointment Managing/Billing and Collection: Schedule patient appointments for the Behavioral Wellness Department and records the appointments into the computer. Notifies patient of scheduled appointment with assigned provider (counselor, psychiatrist), date and time. Scheduled, reschedules, or cancels appointments as requested by patients. Communicates with consulting provider (therapist/psychiatrist) and their designated staff to facilitate and coordinate patient appointments. Accurately entered data and maintains current computer files regarding patient demographics, insurance, and account information. Initiates notes and phone notes to other personnel to alert information regarding a patient, as necessary. Calls to remind patient of their appointments. Follows up on the no show appointments, as necessary. Assures provider’s schedules are populated. Efficiently addressed any discrepancies in the scheduling process. Must maintain full schedules at all times for assigned providers. Bills and collects from patients as per policies and procedure of each specific program or grant. Efficiently address any discrepancies in the billing or collection process. Enters payments received on accounts, applies payment to existing charges and ensures account balances are current and correct. Reconciles and balances daily. Charges are calculated based on sliding scare fee schedule. Will be crossed trained on the Registration Process and duties.

Team communication: Works closely with Behavioral Wellness Counselors, consulting psychiatrist, and social workers to coordinate appointments, relays messages between respective providers regarding patient care. Actively participates and attends meetings as assigned as a representative of the Behavioral Wellness Department. Approaches patient care as a team involving clinical and non-clinical staff (examples physicians, mid-levels, educators, clerical staff) to achieve patient care objectives, as needed. Attends trainings/meetings when requested. Assures maximum appointments, fills gaps in schedule and provides opportunity for same day access. Demonstrates proficiency in phone notes, quick text, medication refills, clinical list updates, flags/alerts, accessing schedules, creating/editing, completing order and documents, Adheres to all HIPAA and CFR, Part 2 2 regulations in and outside of the clinic.

Management of documentation: Utilizes Athena referral process (EMR) to track status of patient appointments in EMR to reflect pending or completed appointment status to facilitate billing. Assures all billing and collection documentations is accurate and current. Documents all adjustments and or refunds as needed. Assists in the annual registration renewal process. Encourages patients to sign up for patient portal. Submit quick text to Medical Records indicating patient kept appointment. Reviews patient encounter file daily to verify charges and obtains proof of financial coverage. Provides patients with registrations information when needed. Verified insurance eligibility and enters into system. Completes all patient visits upon receiving the disposition notice from the provider or patient. Receives and posts cash, checks, or credit card payments for services rendered in the Behavioral Wellness clinic. Maintains a cash box and prepares a deposit closing report and submits report to the responsibility party on a daily basis. Maintains weekly and monthly reports.

Demonstrates safe professional conduct: Maintains a friendly environment for self and others. Refrains from texting and speaking on the cell phone. Refrains from informal communication with patients and others. Fully participates in performance improvement and follows all Clinic policies and procedures. Responsible for their own safety as well as the safety of others. Attends work on a regular and predictable schedule in accordance with clinic leave policy and performs other duties assigned. Submits required documentation in a timely manner (credentialing requirements, license renewals, certifications, Continuing Education attendance, etc)

POSITION DIRECTLY SUPERVISED: None

KNOWLEDGE, SKILLS, AND ABILITIES: (use of equipment, job related knowledge, language, etc.)

Knowledge of PCMH Model

Knowledge of SC policies and procedures

Knowledge of medical billing practices

Knowledge of ICD-9 and ICD-10 coding

Knowledge of computer software (Microsoft Word, Excel, etc.)

Knowledge in the use of electronic mail

Skilled in customer relations

Skilled in the use of a computer

Ability to provide effective customer service on a daily basis

Ability of read, write and spell correctly

Ability to maintain and effective and professional working relationship with the public and co-workers

Ability to bend, stretch, stoop, stand, sit and lift up to 20 lbs

Ability to operate a keyboard, telephone, scanner and other office equipment

Ability to examine documents for accuracy and completeness

Ability to prepare records in accordance to detailed instructions

Ability to communicate fluently in English and Spanish

Ability to maintain a positive work environment

Ability to work in a fast paced environment

Ability to maintain a flexible work schedule

Ability to maintain client and office confidentiality

Ability to fully comply with the enhanced infection control requirements of the clinic

MINIMUM QUALIFICATIONS/CERTIFICATES/LICENSES/REGISTRATIONS REQUIRED:

High school diploma or GED. Experience in appointments, scheduling, coordinating a schedule, calling to confirm and registrations. Must be able to display professional and courteous customer service in answering telephone, providing information to patients in a healthcare setting or social service agency with knowledge of medical terminology. Must be bilingual English/Spanish. Must be familiar with private insurance, Medicare, and Medicaid claims filing.

Experience with CPT and ICD-9/ICD-10 coding.

Experience in obtaining prior authorizations and billing experience.

SPECIAL INSTRUCTIONS: This position requires handling cash, collections, payments, billing, purchasing or inventory duties and as such will require taking no less than five (5) consecutive days of accrued annual leave days per year. Therefore, five of the accrued annual leave days will be reserved for this purpose. This position requires travel. Employee must provide transportation. If employee operates a personal motor vehicle in the performance of their official duties, the employee must possess a current valid Texas driver’s license for the appropriate type of vehicle and Texas Liability insurance. This position requires that an employee’s driving record be verified with law enforcement to ensure compliance with SC’s driving policy

Due to the nature of SC Services, it may be necessary for employees to work extended hours or other variations of the usual shift to ensure adequate care to patients and to maintain service to the community.