Clinical Review Scheduling Specialist I
Arlington, TX US
Area of Interest:
Texas Health Resources System Services
Texas Health Resources seeks to hire a Full Time Clinical Reviewer for the Enterprise Scheduling Department at the Chase Building.
The schedule would be Monday - Friday 9:30a-6:00p
The Clinical Reviewer will be responsible for reviewing all, in-scope incoming orders for Enterprise Scheduling. The Clinical Reviewer will ensure that orders are valid, appropriate and complete before moving them on to be scheduled.
The ideal candidate would possess the following:
High School Diploma or Equivalent is required
5 years in radiology scheduling for a hospital.
Excellent written and oral communication.
Demonstrates the ability to work with little supervision.
EPIC Cadence experience preferred
*Review Orders for appropriateness and completeness
Process incoming orders via Trace in a timely manner. Review orders to ensure criteria are met for valid order status. Document order management in Rad Notes accordingly.
• Determine if order has been used for prior visit/validate if less than 1 year old/
• Compare data from different sources (Careconnect/Trace/Protocol) to determine the course of action for managing orders.
• Review patient exam history/date for indications-consideration of patient age/history/family history/results from last exam, or most recent symptoms.
• Review order to identify any exceptions for using order more than one time (eg. orders for repeat studies or SDOstanding delegate order), or need for contingency exam is necessary.
• Perform Medessary checks for medical necessity for all patients with Medicare as a payor. Perform necessary documentation steps with PixCert and Careconnect.
*Ensure accurate and necessary data sets are present all orders
Patient's Demographics/Date order was written/Provider's signature with credentials/Specific test/Service ordered/Diagnosis/Symptom to support reason for diagnostic test/study. Must include
diagnosis/description(narrative) and valid ICD code for medical necessity validation. Recurring orders must include frequency and duration.
*Communicate effectively with physician offices on incomplete orders
Contact the provider's office to inform them an order has not been received and is required, or does not meet the required standards for outpatient orders.
• Clearly articulate the reason for order status to the provider in a manner that supports the appropriate diagnosis or procedural need.
*Build relationships with physician offices to further than advancement of the department objectives
*Parse and Index incoming orders to appropriate destination
Ensure accuracy of indexing correct fields: Name/DOB/Physician name/Service department.
• Determine In-Scope Radiology orders vs Out-of-Scope orders/ Refer to ES Permissions' list
• Magic Fax orders
• Documenting Initial Review Status/Documenting Current Review Status/Marking Complete/Updating Date of Service
*Complete order review in an extremely tight turnaround time
Texas Health Resources is one of the largest faith-based, nonprofit health care delivery systems in the United States and the largest in North Texas in terms of patients served.
Texas Health has 25 acute-care and short-stay hospitals that are owned, operated, joint-ventured or affiliated with the system. It has more than 3,800 licensed beds, more than 21,100 employees of fully-owned/operated facilities plus 1,400 employees of consolidated joint ventures, and counts more than 5,500 physicians with active staff privileges at its hospitals.
At Texas Health, we strive to create an atmosphere of respect, integrity, compassion and excellence for all who come in contact with us, be they patients or our employees. We are committed to diversity in our workforce, and our mission to serve spreads across ethnic, cultural, economic and generational boundaries. We invite you to join us in furthering your career through our accomplishments and philosophy of excellence.