Health Program specalists

Job Type: Regular

Time Type: Full time

Work Shift: Day (United States of America)

FLSA Status: Non-Exempt

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

The Health Program Specialist (HPS) is responsible for coordinating, interacting with and providing high levels of customer service for all executive health and international patient referrals, and interacting with corporate representatives and major referring physicians and insurance providers in person and on the phone. The HPS provides concierge level customer service to visiting patients and their families including, coordination of care and admissions, scheduling and facilitating appointments, transfers, lodging and interpretation services if/as necessary. Additionally the HPS will Counsel self pay patients regarding costs and potential costs relative to selected procedures and obtain payments from Self Pay patients via wire transfers or Credit cards. The HPS will also help maintain database tracking physician referral sources, discharge reporting to case management and counseling of self-pay patients

Job Description:

Essential Duties & Responsibilities including but not limited to:

• “Triage” of patient calls to identify type and level of service necessary
• Pre-Certification and authorization of patient insurance carriers
• Preoperative screening with referral source
• Obtaining Preoperative clearance from referring physicians and coordination of care with Lahey Clinic Medical Staff
• Obtains appropriate diagnostic and test resources such as patient X-rays and treatment records from referral sources abroad
• Schedules patients' appointments with appropriate Lahey Clinic medical staff and support services
• Coordinates admissions of patients as necessary
• Schedules patient surgeries using CMS, RMS, IDX, Meditech systems
• Coordinates care plans with Case management and Primary Care or referring physician, notifies insurance carriers and receives authorization for and documents coverage accordingly.
• Provides discharge reporting to case management
• Accurately identifies and selects appropriate CPT codes for procedures
• Counsels Self Pay patients of costs and potential costs relative to selected procedures
• Obtains payments from Self Pay patients via wire transfers or Credit cards
• Schedules Lahey medical staff new patient and follow up appointments with patients at referral source
• Arranges air ambulance transportation to Lahey Clinic for patients in need of urgent care
• Incorporates Lahey Clinic Guiding Principles, Mission Statement and Goals into daily activities.
• Complies with all Lahey Clinic Policies.
• Complies with behavioral expectations of the department and Lahey Clinic.
• Maintains courteous and effective interactions with colleagues and patients.
• Demonstrates an understanding of the job description, performance expectations, and competency assessment.
• Demonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards.
• Participates in departmental and/or interdepartmental quality improvement activities.
• Participates in and successfully completes Mandatory Education.
• Performs all other duties as needed or directed to meet the needs of the department.
  
  

Minimum Qualifications:

Education:

• Associates degree
  
  

Licensure, Certification, Registration:

• No license required.
  
  

Skills, Knowledge & Abilities:

• Ability to receive and respond to patient calls and to discern level and type of care or response required.
• Knowledge of medical terminology and experience with common general medical practices, procedures and techniques
• Skilled using common medical office and clinical practice technologies such as: IDX, Medi-tech, CMS, RMS and or other clinical data base systems.
• Ability to provide exceptional customer service in person or via telephone.
• General knowledge of Professional and Technical Codes (CPT) used for billing procedures.
• General knowledge of domestic insurance billing process and requirements.
  
  

Experience:

• Three or more years of experience typically gained in a clinical health care setting handling confidential and sensitive patient information.
• Strong knowledge of, or experience with common medical office equipment as well as demonstrated expertise with medical office software program applications a must.
• Demonstrated exceptional customer service skills, be efficient, detail oriented, and highly organized, with very strong communication skills.
• The ability to multitask and respond to shifting priorities in a fast-paced environment is necessary.
  
  

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled