Patient Access Specialist - Chambersburg - Days

Position Function: Obtain complete and accurate collection of patient demographic information. Serves as the initial contact for patient access. Responsible for insurance verification, scheduling, registration and authorizations of patients’ studies.

Shift

Part Time, Mon-Fri 730a-8p, Sat 8a-12p. 20 hours a week.

Essential Functions and Responsibilities
Unit Based Essential Functions and Responsibilities

Core Values: Service, Integrity, Compassion
1. Demonstrates service excellence and patient and family centered care by showing respect, honesty, fairness and a positive attitude toward all customers.
2. Maintains confidentiality.
3. Demonstrates dependability, to include attendance and punctuality.
4. Is accountable - takes initiative and ownership of issues.
5. Displays a professional demeanor. Represents hospital in a positive way. Has a compassionate working relationship with patients and families.
6. Assumes personal responsibility for 2-way communication. Communicates and listens effectively with patients, families, coworkers, other departments, physicians/providers and community.
7. Supports coworkers, initiatives and a patient and family centered philosophy; pitches in; does own part and helps others.
8. Works to continuously improve work environment/processes (Performance Improvement). Demonstrates a patient and family centered focus when considering/developing improvement solutions.
9. Represents willingness/enthusiasm to create, embrace and facilitate change.
10. Develops self and others; supports a learning environment; leads by example. Encourages patients and families to give feedback and suggestions for improvement.
11. Develops working relationships critical to the organization including patients, families, coworkers, other departments, physicians/providers and community.
12. Encourages others by providing recognition and support.

Technical Excellence
1. Thinks critically; utilizes sound judgment; promptly reports potential risks.
2. Maintains state of art knowledge of area of specialty, healthcare trends and practice, and populations served.
3. Maintains a level of computer literacy appropriate to their role.
4. Meets and maintains current all unit specific and organizational skills/competencies, certifications/licensures, as required.
5. Completes hospital-required reviews, e.g. HIPAA, safety, health screening, care concerns, and others as assigned.
6. Adheres to National Patient Safety Goals.

Job Class Specifics
1. Maintains all equipment in a safe working condition; notifies supervisor of malfunctioning equipment or unsafe acts/conditions immediately. Maintains a neat, clean work area; communicates to Environmental Service as appropriate.
2. Identifies oneself in all telephone conversations. Portrays a friendly tone when speaking on the telephone.
3. Prioritizes workload at beginning of shift and throughout, so that time lines and volume of workload done minimized patient waiting time.
4. Prepares for next day’s schedule; obtains/retrieves requested data/schedules, etc. to promote efficient low of workload.
5. Processes patients in a timely and accurate manner.
6. Runs required report(s) as assigned.
7. As assigned completes statistical reports.
8. Organizes and files required information in the appropriate EMR chart.
9. Performs other related duties as assigned.
10. Utilizes on-line Intranet tools.
11. Documents data accurately on the patient account for use within the department.
12. Scans all appropriate documents into system including doctor order, eligibility documents, and authorizations.
13. Maintains a high degree of accuracy in the collection of demographic and insurance information.
14. Strives to avoid creating duplicate medical record numbers.
15. Understands Medicare and Medical Assistance regulations as they apply to registration of patients. Adheres to regulations.
16. Utilizes Worklist and other Reports.
17. Follows add-on process for tests/procedures regarding scheduling for authorizations/referral process.
18. Reviews scheduled bookings to certify coordinating requirements, order entry, pre-registration and insurance information; verifies/documents pre-certification and medical necessity requirements prior to exam.
19. Completes other competencies as required.
20. Performs all duties in accordance with departmental and organization policies and procedures and good customer service principles.
21. Provides effective training and cross training in a timely manner; willingly accepts new and/or additional responsibilities.
22. Listens actively to complaints without being defensive and refers to manager as appropriate.
23. Attends staff meetings/in-services related to his/her area.
24. Meets performance/productivity standards for assigned duties.
25. Informs manager of supply needs to maintain forms, materials, equipment, and supplies inventory

Additional Specifics for Scheduling Team
1. Reviews patient order, assuring that correct ordering doctor is listed on all orders.
2. Completes patient scheduling queries as necessary for scheduled tests/procedures.
3. Receives requests for scheduling tests/procedures by accurately and effectively using the telephone and scheduling systems to complete requests received from patients, physician’s offices, nursing homes, nursing floors, and schedules tests/procedures appropriately in accordance with departmental guidelines. Instructs caller as appropriate on required exam preps or lab tests for requested procedures.
4. Specialists logs on to telephone system and schedules all tests/procedures in system as received either by phone or fax requests.
5. Schedules patient procedures/appointments in accordance with departmental procedures; mails confirmation letter and related information to patient as per departmental procedures as directed.
6. Receives and posts payments for services provided to patients.
7. Strives to avoid creating duplicate medical record numbers.

Additional Specifics for Insurance Verification Team
1. Verifies insurance coverage and benefits according to department procedures.
2. Develops knowledge of insurance and their requirements. Refers to specific information provided in the Epic system.
3. Utilizes various software programs for insurance verification.
4. Notifies ordering provider of authorization status.
5. Obtains authorizations and referrals as required by insurances.
6. Notifies appropriate facility of waiver forms when appropriate.

General Requirements

The following requirements are expected of all employees:

Core Values: Integrity, Compassion, Excellence, Service
Annual Health Screening with Infection Control and Blood Borne Pathogens Education
Safety Awareness: Hospital Fire, Safety, and Disaster procedures
Confidentiality: Maintains employee and patient confidentiality.
Attendance: Regular attendance is an essential function of the position
Leadership Standards:
Character: Attitude, Integrity, Role Modeling
Job Performance: Results orientation, Customer focus, Decision making, Awareness
Interpersonal Skills: Communication, Relationship-building, Team player, Celebration, Bi-lingual preferred.
Innovation: Breakthrough Thinking, Knowledge-Building/Sharing, Coaching/Empowering, System Vision & Management

Working Environment: Work is performed in a clean, well-ventilated indoor environment; requires standing and walking.

Reporting Structure: Reports to the Assistant Manager/Manager of Patient Access. In the manager's absence, reports to the Director of Patient Access.

Disclaimer: These essential job functions are requirements of the position, which must be performed either with or without reasonable accommodation. The essential job function list is intended to be a guide rather than a limitation. The Chambersburg Hospital possesses the right to add new responsibilities to the list as business demands dictate. Some of the essential job functions may exclude individuals who pose a direct threat/significant risk to the health and safety of themselves or others.

By identifying essential job functions, we are in no way stating or implying that these required tasks are the only activities that are to be performed by the employee occupying this position. In addition, employees will also be expected to follow any other job-related instructions and to perform any other job-related duties that are included in the job description. The preceding requirements represent only the minimum acceptable levels of knowledge, skills, and/or abilities that a job incumbent must possess; in order to perform the job successfully, the incumbent will possess additional aptitudes so as to perform the other duties that the job description entails.

Qualifications and Standards

Education: High school graduate or equivalency required. Completion of a medical terminology course; completion of medical program i.e., Certified Coding Specialist, Medical Billing and Coding, Medical Assistant or equivalent in experience is required.

Experience: Experience applying customer service behaviors and communication skills required. Experience in insurance verification, scheduling, registration and authorization preferred. Minimum typing speed of 40 words per minute, knowledge of insurances, and computer literacy required.

Certifications/Licensure: Certification by the Healthcare Financial Management Association (HFMA) of Certified Revenue Cycle Representative (CRCR) is preferred.