Sr Patient Access Rep

Description
ENTRY REQUIREMENTS
Education

• Medical Terminology required or successful completion of medical terminology course within 90 days of hire.
• Associates Degree or 2 years formal education or equivalent experience
• Preceptor training required.

Work Experience

• Minimum of one (1) year experience in customer service, healthcare or business field and an additional 1 year in Patient Financial Services, including 6 months in Patient Access Services as a Patient Access Representative required. (2 years total

Keyboard – Computer Skills

• Smart Web
• RightFax
• Sunquest
• Versus
• Mayo Internet
• HBOC Cash Posting
• 3M Coding
• RadNet
• STIX
• Mysis
• PHS
• OTG Scanning
• FirstNet
• GUI/Star
• PowerChart
• Advanced GroupWise
• HealthWorks
• Insurance verification systems
• Tempus One scheduling
• Must be able to pass a typing test of at least 40 words per minute with under 6 errors.
• Knowledge of ICD-9-CM tables preferred.
• Advanced keyboard, mouse, computer and Microsoft Office skills. Must have knowledge and ability to learn, access and utilize 10+ of the computer programs listed below within 90 days of hire, when appropriate for respective department.

Other Entry Requirements

• 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 responsibilities.
• 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.
Organizationally reports to the Director of Patient Access 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.
AGE OF PATIENTS SERVED
Cares For Patients In The Age Category(s) Checked Below
X_No direct clinical contact with patients
SPECIFIC DUTIES

• 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
• Able to establish priorities and meet tight deadlines with strong problem solving ability
• Has basic understanding of Relationship-Based Care (RBC) principles, meets expectations outlined in Commitment To My Co-workers, and supports RBC unit action plans.
• Embraces and supports the Performance Improvement philosophy of Munson Healthcare.
• Promotes personal and patient safety.
• Is cross-trained to support multiple areas within Patient Access Services.
• 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.
• Performs other duties as assigned by the PAS leadership team.
• Works well under general guidance.
• Supports the Mission, Vision and Values of Munson Healthcare
• Exercises a high degree of control over confidential medical information.
• Uses effective customer service/interpersonal skills at all times.

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.
Collects and releases patient valuables envelopes assuring proper patient identification.
Provides outstanding customer service to physician’s 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 ICD-9-CM Diagnosis and Procedure codes, when appropriate, using 3-M Coding software or ICD-9-CM 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 Development 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.
Identifies the need for pre-authorization information, makes decisions relating to insurance eligibility utilizing several on line systems available to MMC. Obtains and documents pre-authorization as appropriate for procedure. Responsible to keep current on all billing requirements from third party carriers.
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
May assist with working various reports, including but not limited to, PRT Past Expected Date, MSP, Verification Follow-up, Rejection, and Address Error.
Scheduling
Uses Tempus One software to schedule various appointments. This includes, but is not limited to, ARTC appointments, Non-interventional Radiology and misc. therapies.
Registrars with scheduling assignments can expect their duties to be adjusted with the growing demands of our customers.
Additional Emergency Department Duties
Bedside registration
Provides coverage for admitting team from 11:00 pm to 7:00 am.
Perform PRT turnovers.
Breakdown charts
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