POSITION SUMMARY

Act as customer service agent and point of contact for patient clinical inquiries and needs by answering  patient telephone calls, ascertaining the problem or question, assessing the degree of urgency and following  through to provide a response.

MINIMUM REQUIREMENTS

Education:

1. Completion of an accredited registered nurse program required.

Experience:

1. Three years of hospital nursing experience RN or prior triage experience preferred.

Knowledge, Skills, Abilities:

1. Knowledge of the practical nursing principles and skills needed to provide quality patient care and treatment including medications effects on patients.
2. Knowledge of physician office procedures, medical terminology, ICD-9 and CPT coding guidelines.
3. Ability to communicate clearly and effectively and read, understand and follow written and verbal instructions of the physician.
4. Must be able to react calmly and effectively during emergency situations.
5. Must have the ability to identify and analyze problems, prioritize, make confident quick decisions and recommend effective care solutions per protocol.

License/Certification/Registration:

1. Registered Nurse in the State of Pennsylvania.
2. Meets the American Heart Association’s standards for Healthcare Provider Basic Life Support (BLS) and renews BLS every two years.
3. Within four (4) months of hire/transfer, meets the American Heart Association’s standards for Healthcare Provider Advanced Cardiac Life Support (ACLS) and renews ACLS every two years.

SUPERVISION RECEIVED

Receives (general, minimal, direct or indirect) supervision from the Nursing Supervisor

SUPERVISION GIVEN

None

ESSENTIAL FUNCTIONS

1. Screen and prioritize patient telephone inquiries concerning their medical care, prescription refills, insurance authorizations and referrals and record information in patient chart.
2. Follow-up on inquiries until the issue is resolved completely and satisfactorily.
3. Evaluate and respond appropriately to urgent or emergency situations.
4. Coordinate patient referrals, pre-certification and pre-authorizations and appointments to outpatient facilities, specialists and hospitals including preparing insurance referrals, obtaining insurance pre-authorizations, explaining procedures, treatments, prep instructions and medication changes to patients and family members where appropriate.
5. Contact patients to relate test results and care instructions, according to physician instructions.
6. Call pharmacies with patient prescriptions according to physician’s instructions and protocol.
7. Document patient information, test and examination results and care provided in the patient’s paper or electronic health record.
8. Using the Electronic Health Record, document and bill for services rendered.
9. Perform other duties as required.

NON-ESSENTIAL FUNCTIONS

Performs related and miscellaneous duties as assigned.