Practice Operation Specialist

Patient Communication & Scheduling

·         Answer all incoming calls professionally, with empathy and courtesy.

·         Schedule acute/same-day appointments for urgent cases, making appropriate notes in the EMR.

·         Schedule follow-up appointments for chronic condition patients every 3 or 6 months as directed.

·         Schedule annual wellness visits for Medicare patients and complete physical exams for commercial and Medicare Advantage patients.

·         Understand and communicate that the practice does not accept Medicaid or self-pay patients; we are a non-participating physician.

·         For medication refill requests: Identify and prioritize controlled substance requests; schedule an appointment before refilling.

·         If the patient has not been seen in 6+ months, schedule a visit. If out of diabetic or hypertension medication, confirm the pharmacy, advise of a possible emergency 30-day supply, and schedule urgently.

·         For out-of-state refill requests, obtain and import the temporary pharmacy into the EMR, set it as primary, and send a high-priority message to the physician on duty.

·         Manage follow-up calls for patients who checked out without scheduling a return appointment.

Insurance & Billing

·         Verify patient insurance coverage and outstanding balances before appointments using eClinicalWorks (eCW) or insurance provider portals.

·         Confirm insurance eligibility and document verification in the EMR.

Patient Data Management

·         Accurately capture and update patient demographics, mobile numbers, home numbers, and email addresses; double-check for accuracy.

·         Confirm caller identity using patient name and date of birth; verify authorized contact list before discussing protected information.

Medical Records & Documentation

·         Monitor scanned folders (EKG, UA, and other diagnostic documents) and correctly assign them to the patient chart.

·         Manage scanned physician orders in Certification/Recertification folders and submit to insurance for payment as instructed.

·         Process medical record requests from third-party companies only after payment is received ($100 per chart).

·         Process patient-authorized medical record requests after confirming no unpaid balances; obtain signed authorizations.

·         Monitor incoming e-faxes in the EMR and route appropriately.

Patient Experience & Escalations

·         Handle unhappy or irate patients with patience and professionalism; escalate to leadership when necessary.

·         Maintain zero tolerance for rudeness or lack of empathy toward patients—patient satisfaction is the highest priority.

·         Always thank patients for choosing our practice.

Compliance & Privacy

·         Maintain strict confidentiality of all patient information in compliance with HIPAA and practice policies.

·         Never remove or copy patient data outside of the office. Any written notes with patient information must be shredded at the end of the workday.

Other Duties

·         Perform any other related tasks as assigned by leadership. Training will be provided for new responsibilities as needed.