Patient Access Representative
ENTRY REQUIREMENTS Education: Associates Degree or 2 years formal education or equivalent experience. Medical Terminology required or successful completion of medical terminology course in the probationary period. Failure to complete medical terminology will result in termination of employment. Work Experience: Two (2) years work experience in customer service, healthcare or business related field. Keyboard - Computer Skills: Advanced keyboard, mouse, computer and Microsoft Windows skills. Must have knowledge and ability to learn, access and utilize 10+ of the computer programs listed below in the probationary, when appropriate for respective department. The applicant will be expected to learn and maintain proficiency in all other applications relative to the position:Microsoft Word and Excel, Current email system - Outlook, RightFax, GUI/Star, 3M Coding, Insurance verification systems, Smart Web, OTG scanning, Power Chart, Current scheduling systems, Cerner Applications, HealthWorks, STIX, Versus, Sunquest, Mysis, HBOC Cash Posting and Apex, Applicable EMRs, Huron Applications. Must be able to pass a typing test of at least 40 words per minute with under 6 errors. Other Entry Requirements: Knowledge of ICD coding preferred, proven ability to communicate effectively with both public and co-workers orally and in writing, and the ability to work positively with all levels of staff in completion of job responsibilitiesand the person must be highly mobile to assist patients, family and visitors when needed. ORGANIZATION Under the general supervision of the Manager, Patient Access Services and the Patient Access Services Coordinator(s). Organizationally reports to the Director of Patient Financial Services. May receive input/instructions from on site clinical managers and Patient Financial Services Director. Must be self-directed, motivated and able to work independently. Working relations with all ancillary departments and co-workers. SPECIFIC DUTIES Supports the Mission, Vision and Values of Munson Healthcare. Embraces and supports the Performance Improvement philosophy of Munson Healthcare. Has basic understanding of Relationship Based Care (RBC) principles, meets expectations outlined in Commitment To My Co-workers, and supports RBC unit action plans. Promotes personal and patient safety. Uses effective customer service/interpersonal skills at all times. Is required to meet minimum quality and productivity scores as defined by management. Works well under general guidance. Able to handle frequent demand of shifting priorities and deadlines with a broader scope of complexity. Must possess exceptional people skills. Greets patients, family members and other customers in a courteous and welcoming manner. Ask for and provides all information necessary to promote patient understanding of procedures, expectations, and the hospital environment; exchanges all information in a friendly, kind manner. Exercises a high degree of control over confidential medical information. Keeps offices and work area orderly and properly stocked. Responsible to access department communications daily utilizing telephone voice mail and/ or e-mail. Expected to make immediate requested changes to current information collection procedures utilizing daily communications. This is often requested before official documentation of changes. Acts as a preceptor for new hires to provide all levels of education required for that position. Performs other duties as assigned by the PAS leadership team. Customer Service Responsibilities: Greets and directs patients and/or families to testing and surgical areas in the facility. Transports or arranges for transportation of patients via wheelchair, as needed. Provides outstanding customer service to physicians and offices, MMC departments and patients. Registration Responsibilities: Obtains/verifies all required patient information and enters the information into the registration system following the screen flow in an accurate manner. Completes all assigned registrations in an expedient manner subject to department requirements. Reviews completed registration forms with patient before releasing to patient care areas. Responsible for distribution and documentation of the Privacy Notice for HIPAA regulations. Documents presence of Advance Medical Directives and provides information for all adult patients. Provides Patient Rights information. Explains authorization of treatment, release of medical records, assignment of insurance benefits, and HIV testing in the event of an accidental exposure and secures signature from patient. Contacts family of minor children presenting for care to secure permission for treatment when guardian is unavailable. Coding/Medical Necessity/ABN: Provides appropriate diagnosis and procedure codes, when appropriate, using 3-M Coding software or coding book. Responsible for screening medical necessity and distribution of Advance Beneficiary Notice on all appropriate procedures and tests. Insurance Responsibilities: Educates and informs patients of insurance requirements as needed. Inputs and updates all insurance information in appropriate screens. Verifies eligibility of all insurances available on line.Follow up on all verifications not retrievable in a timely manner and consult with the Insurance Verification Team on any problem cases. Identifies primary and secondary insurance. Sequences Blue Cross/Blue Shield, Medicare, Medicaid, Workman's Compensation, Commercial and Auto Insurance as appropriate. Obtains claim numbers and verifies that claims are established for Workmen's Compensation and Auto Insurance. Collection Responsibilities: Refers patients to Assistance Coordinator to obtain financial assistance and/or refers patients to Patient Accounting for payment arrangements when appropriate. Collects cash/credit card payments on accounts for deductibles, co-pay, patient balances, including monthly statements. Prepares and balances daily bank deposits. Reports: Assists with working various reports, including but not limited to, PRT Past Expected Date, MSP, Verification Follow-up, Rejection, Failed Bill and Address Error and Huron Work lists. Scheduling: Uses appropriate scheduling systems to schedule various appointments. Registrars with scheduling assignments can expect their duties to be adjusted with the growing demands of our customers. Additional Emergency Department duties: Bedside registration. Perform PRT turnovers. Follows ED's additional patient identification protocol. Follow "DOE" process for unidentified patient. Combine accounts when a DOE is identified. Register after hours patients for all services. Ability to work in a crisis environment. Prioritize patient registrations based on level of care required. Additional Urgent Care duties: Upon completion of the nursing assistant short course, some Patient Access Representatives at the Urgent Care will perform some or all of the following: Vital signs, history Intakes, ice packs, wheel chair transports, obtain urine samples for testing, point of care testing, ie Urine tests; rooming patients and preparing them to be seen by provider.