About Wilmington Health

Since 1971, Wilmington Health has been committed to the care and health of our community in Wilmington as well as all of Southeastern North Carolina. Wilmington Health is structured as a multi-specialty medical practice with primary care providers integrated into the system. In this way, Wilmington Health is able to provide a comprehensive and coordinated approach to the care of all our patients. Wilmington Health is committed to using collaborative, evidence-based medicine in providing the highest quality of care to the patients we serve.

Purpose:

The Appointment Scheduling Specialist is responsible for managing patient appointments, providing outstanding customer service, and ensuring efficient coordination of medical services. This role includes scheduling appointments, verifying insurance information, handling patient inquiries, and ensuring accurate entry of patient details. The Specialist plays a crucial role in maintaining smooth communication between patients, providers, and office staff.

Essential Duties/Responsibilities:

Phone Management

• Handle all incoming calls from patients to schedule appointments for medical care, and screening and diagnostic testing.
• Provide exceptional customer service by addressing patient inquiries, concerns, and requests with empathy and professionalism.

Appointment Scheduling

• Schedule, reschedule, confirm, or cancel patient appointments as requested.
• Make new patient appointments, ensuring that all demographic and insurance information is entered accurately into the system.
• Communicate effectively with patients to confirm appointments, provide necessary pre-appointment instructions, and answer any questions.
• Utilize scheduling software to coordinate and organize patient appointments efficiently.
• Work closely with healthcare providers to accommodate urgent and specialized appointment requests.

Patient Communication

• Provide appointment reminders, including office locations, required paperwork (mailed or available on the website), and any balance due on the account.
• Explain relevant health plan information and assist patients in understanding their coverage.
• Communicate promptly with patients regarding any schedule changes, cancellations, or adjustments.

Data Entry and Insurance Verification

• Enter and update patient demographic information, including policyholder details and insurance information.
• Verify insurance coverage, including Tricare and Medicaid, ensuring accurate information is reflected in the system.

Rescheduling and Provider Coordination

• Reschedule appointments when providers are out of the office and communicate changes to patients, collaborating with office staff when necessary.
• Communicate schedule changes or adjustments to relevant staff members promptly.

Financial Responsibilities

• Collect copays for same-day virtual visits and ensure proper documentation is maintained.

Other Duties:

• Other duties as assigned.

HIPAA, Security, and Privacy Requirements:

• HIPAA Compliance
• Ensure all Protected Health Information (PHI) is handled in accordance with the Health Insurance Portability and Accountability Act (HIPAA).
• Maintain confidentiality of patient records, medical history, billing information, and other sensitive data.
• Access, use, and share PHI only as necessary for billing and claims processing purposes.
• Data Security
• Follow organizational security protocols to safeguard electronic and paper-based patient information.
• Ensure secure storage and transmission of PHI, including the use of encrypted systems or platforms approved by the organization.
• Adhere to password management policies, two-factor authentication, and other security measures to protect access to the Practice Management and billing systems.
• Privacy Protection
• Maintain a strict “need to know” basis for accessing patient information.
• Follow procedures to minimize unauthorized access to patient records, whether physically (in-office) or digitally (online systems).
• Promptly report any security breaches or unauthorized access incidents to the appropriate department or compliance officer.
• Documentation and Auditing
• Accurately document all actions involving patient information to ensure a clear audit trail, including billing, claims processing, and collections activities.
• Participate in regular audits and reviews of billing practices to verify compliance with HIPAA and security regulations.
• Training and Continuing Education
• Complete required HIPAA and security training as mandated by the organization.
• Stay updated on changes in healthcare privacy laws, HIPAA regulations, and organizational policies regarding patient data security.
• Incident Reporting
• Recognize and report any potential privacy or security violations, including unauthorized access to PHI, data breaches, or suspicious activities, following the organization’s incident reporting procedures.

Qualifications:

• Education: High school diploma or equivalent.

Required:

• Previous experience in a medical office or similar role, particularly in appointment scheduling and patient interaction.
• Strong communication skills, with a focus on empathy and active listening.
• Proficient computer skills, including experience with scheduling software and electronic health record (EHR) systems.
• Ability to multitask and prioritize in a fast-paced environment.
• Attentional to detail and accuracy in data entry.
• Excellent communication and interpersonal skills.
• Ability to manage high volumes of calls and multitask in a fast-paced environment.
• Friendly and professional demeanor.
• Ability to handle patient inquiries with empathy and resolve issues in a timely manner.
• Adaptable to changes in scheduling and able to work under pressure.

Preferred:

• Familiarity with insurance plans such as Tricare and Medicaid.

ADA Physical Demands:

Rarely (Less than .5 hrs/day) Occasionally (0.6 – 2.5 hrs/day) Frequently (2.6 – 5.5 hrs/day) Continuously (5.6 – 8.0 hrs/day)

General Competencies

To perform the job successfully, an individual should demonstrate the following competencies:

• Customer Service
• Professionalism/Integrity/Responsibility
• Teamwork/Process Focus
• Dependability/Punctuality
• Interpersonal Relationships/Communication
• Judgment/Decision Making/Problem Solving
• Quality/Quantity
• Initiative
• Safety and Housekeeping
• Organizational Skills/Time Management
• Quality Management