JOB PURPOSE OR MISSION: Provides excellent customer service during the patient access/intake process, executing patient access through the continuum of the revenue cycle that supports efficiency, cost reduction and service improvement. Performs duties according to established hospital procedures for the age population served, as defined in the department’s scope of service. Verifies insurance benefits process for patient admission. JOB FUNCTIONS ESSENTIAL JOB FUNCTIONS include, but are not limited to: 1. Facilitates patient safety with accurate and timely patient identification. PERFORMANCE STANDARDS:
• Follows all policies and procedures to accurately identify the patient.
• Documents on appropriate form any variation form normal process. 2. Timely, accurately and consistently completes the patient access process which include pre-registration and registration. PERFORMANCE STANDARDS:
• Conducts a confidential and professional interview with patients or the patient’s representative and completes pre-registration and registration.
• Patient access functions are completed timely, promoting patient safety and minimizing patient delays.
• Initiates quick registration processes deemed emergent or urgent.
• Promptly performs initial quick registrations on targeted patients and completes the access process as soon as possible.
• Follows all Medical Treatment and Labor Act (EMTALA) regulations.
• Registers patients to the correct location and bed according to information obtained from the nursing unit (inpatient only).
• Maintains compliance in completing all documents required by specific payers for each patient registration.
• Communicates with Insurance Representatives when necessary to effectively promote continuity in pre-certification/insurance verification process.
• Interpret insurance verification data as needed and takes appropriate action related to insurance responses.
• Maintains an overall error rate at or below 5%.
• Documents on appropriate from any variation form normal process.
• Performs duties for one areas of responsibility within the Business Services Department. 3. Computes, requests, collects and receipts monies. PERFORMANCE STANDARDS:
• Reviews and/or collects with the patient co-payments and payments due and documents according to financial policies.
• Researches related accounts’ outstanding debts and discusses with patient as needed.
• Documents on appropriate form any variation from normal process. 4. Performs activation of account according to standard procedures and disseminates chart appropriately. PERFORMANCE STANDARDS:
• Completes activation function of all registered patients facilitating timely patient account functions.
• Disseminates all records and distributes them to appropriate departments according to standard procedures.
• Documents on appropriate form any variation from normal process 5. Greets and receives guests, ascertains their needs, and appropriately directs guests or callers. PERFORMANCE STANDARDS:
• Courteously answers the telephone and receives guests.
• Responds to telephone by the third ring and promptly acknowledges caller.
• Assists guest or caller by answering questions or providing information, and determines when referral to other staff is appropriate.
• Takes accurate messages and repeats key information to ensure accuracy.
• Respects at all times the confidentiality of information.
• Accurately verifies patient insurance benefits.
• Completes admissions paperwork upon arrival of the patient.
• Informs the nursing that the patient has arrived.
• Completes patient registration in the computer system. 6. Demonstrates knowledge of and ability to word process and format standard office documents. PERFORMANCE STANDARDS:
• Consistently completes all work processing assignments accurately.
• Assignments are completed on a timely basis.
• Always proofreads final copy. . Demonstrates effectiveness in operating telephone console to receive, route, and/or place calls. PERFORMANCE STANDARDS:
• Answers all incoming calls within 3 rings.
• Receives, places, and transfers calls using appropriate telephone etiquette.
• Handles telephone requests with courtesy, accuracy and respect for confidentiality.
• Demonstrates responsibility for verbal and paging all emergency/disaster codes according to Policy.
• Places long distance calls for authorized parties only. 8. Schedules appointments. PERFORMANCE STANDARDS:
• Makes appointment schedules and/or transportation availability for all patients, via computer system according to established procedures.
• Coordinates insurance coverage with patients, insurance company, and Business Office as indicated.
• Communicates special patient needs to appropriate staff. 6. Performs all other duties as assigned.
Customer Services Experience Required. Must posses intermediate computer skills with experience in Windows, Excel, Word and Outlook. Prior experience in Insurance or Patient Registration in healthcare environment preferred. One year of higher education or certification in coding may be substituted for experience, as approved by department manager. EDUCATIONAL REQUIREMENTS High School Diploma or GED required, higher education preferred. SPECIAL SKILL, LICENSE AND KNOWLEDGE REQUIREMENTS Must be able to enter data using a computer with multiple applications. Excellent telephone and communication skills. Must possess basic knowledge of medical terminology. HIPAA REQUIREMENTS: Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position including but not limited to: medical record without limitation, patient demographics, lab results, patient financial and 3rd party billing information, patient related complaints, information related to patient location.
Full-Time
