Clinical Assistant III - Pediatric Cardiology - Part Time

Category: 
Job Type: Part-Time
Shift: Days
Location: 
Req: 13067
FTE: 

Who We Are

Packard Children’s Health Alliance (PCHA) is a network associated with Lucile Packard Children’s Hospital and the Stanford School of Medicine. We bring the best community physicians together in a network that provides healthcare for children and expectant mothers from the Bay Area

 

In fact, we’re proud to be the only Bay Area medical network with an exclusive focus on women and children, and we understand the unique value provided by our more than 650 leading pediatricians and obstetrician/gynecologists. What’s more, we’re growing fast.

Clinical Services (PCHA)

The Clinical Assistant III functions as a member of the clinic patient care team and is directed by the Clinic Manager or designee. Performs all clerical duties required to complete patient Check-in/Check-out, answers phones, makes appointments, administers and coordinates the HMO (Health Maintenance Organization) referral and service authorization process, new patient insurance verifications and other clinic front desk activities.

 

Essential Functions

  • Schedules appointments in scheduling systems.  Schedules consultations with other clinics or physicians as needed; schedules complex appointments requiring strong knowledge of procedures, department protocols and timing.
  • Assures appropriate verifications and authorizations are completed prior to scheduling patients.
  • Verifies new patient insurance and ensures that patient has appropriate authorization.
  • Determines when authorization for services is required and ensures authorization is obtained prior to service date.  Determines and documents need for signatures for conditions of registration and Medicare secondary payment screen.
  • Obtains demographics and financial data from new and return patients and completes registration procedures. Functions independently to complete activities related to the registration process.  Responsible for completeness, accuracy, and timeliness of data.
  • Ensures that all scheduled patients are eligible for services requested and /or determines patient eligibility. 
  • Ensures referral authorization is finalized/ approved prior to patient visit; reviews Missing Referral Report document and submits referral authorization document to specialty physician for completion of required data elements, and files or routes documents according to established procedures.
  • Reconciles and processes denied referral and treatment authorizations and notifies patient of denial status and financial implications.
  • Documents patient liability and communicates this information to the patient, and appropriate staff.
  • Serves as resource to other staff in the area of registration, benefits, and authorization process.
  • Reviews and analyzes all registration edit reports, and ensures that corrections to the database are made in a timely fashion.
  • Other duties as assigned.

 

Minimum Qualifications

Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.

Education:  High School diploma or GED equivalent

Experience:  Three (3) years of progressively responsible and directly related work experience

Licensure/Certification:  None required.

 

Knowledge, Skills, and Abilities

These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education, or licensure/certification.

  • Knowledge of medical terminology
  • Knowledge of computer systems and software used in functional area
  • Knowledge of insurance plan limitations on care, requirements for pre-authorization for services, patient obligations for payment and reimbursement/billing requirements
  • Ability to adjust communications to fit the needs and level of understanding of the receiver
  • Ability to plan, organize, prioritize, work independently and meet deadlines
  • Ability to schedule, coordinate and track complex surgery scheduling and multiple patient appointments.
  • Ability to provide leadership and influence others
  • Ability to speak and write effectively at a level appropriate for the job

Equal Opportunity Employer

Stanford Children’s Health strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment.  Accordingly, Stanford Children’s Health does not discriminate against any person on the basis of race, color, sex, sexual orientation or identity, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability. Women and men, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply.