POSITION SUMMARY
This position performs several important functions: (1) registering patients, (2) able to provide guidance to Patient Access Specialist (PAS) Team, and (3) serves as a point of contact to ensure various reports are completed in a timely manner. The incumbent is responsible for interviewing patients and providing assistance to complete required forms to process medical and pharmacy billing claims, collecting and analyzing all patients’ demographic information, third party coverage (i.e. insurance), and data entering clinical elements. Responsibilities include data integrity to further expedite third party reimbursement and optimize customer satisfaction and relations. The incumbent must work day and evening shifts, weekends, and occasional overtime as required. Incumbent takes the lead in ensuring PAS staff are trained and knowledgeable of registration processes, and that workflow processes are efficient, current and accurate.
ESSENTIAL FUNCTIONS
- Provides direction to Sacred Peaks Health Center (SPHC) Patient Access Specialists (PAS) Team.
- Provides PAS team members with tools and training needed to assist in meeting accuracy standard goals, minimize department registration errors, rejections, and avoidable denials. Trains and assists new hires in successfully meeting 90-day productivity and orientation standards.
- Reviews, updates and maintains all patient data in multiple patient accounting, registration and scheduling systems by initiating the completion of forms required for billing and admissions.
- Interviews patients to obtain pertinent registration information, assures document scanning, retrieving and editing, and patient identification to determine patient’s insurance coverage, limitations and communicates to patients any co-pays or deductible for collection.
- Performs insurance verification and prior authorization for patients prior to patient’s schedule appointment or procedure.
- Assists patients in completing and updating forms required for medical records, third party insurer and the facility.
- Identifies and pre-authorizes patients whose health benefits are subject to prior approval to determine the extent of health care for both inpatient and outpatient care.
- Collaborates with various departments to expedite patient services and improve patient satisfaction.
- Incumbent will serve patients and visitors by welcoming and greeting them in person and/or telephone, answering or referring inquiries, directing patients and visitors.
- Complete intake process and coordinate motor vehicle accidents/workers’ compensation claims visits that occur during shift to appropriate personnel.
- Follow all guidelines in regards to patient identification and refer to Patient Benefit Coordinator for all non-eligible Medicaid patients.
- Understand and work with software systems for clinical, medical, dental, pharmacy and other healthcare office systems.
- Attends meetings and provides updates to Sacred Peaks Leadership team and others within the corporation as needed.
- Completes all electronic health record entries accurately and timely pertinent to patient care role.
- Participates in departmental workflow and or testing teams as related to electronic health record initiatives.
- Ensures daily huddles are conducted within PAS Team to enhance vital communication.
- Reviews PAS process workflows and provides feedback for improvement.
- Ensure proper PPE is worn at all times while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield.
- Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates)
- Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction.
- Perform other duties as assigned.
MENTAL AND PHYSICAL EFFORT
The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Physical:
Work is mostly sedentary, with some prolonged sitting; walking; standing; talking or hearing; and, use hands to finger, handle, or feel while interviewing patients and preparing the appropriate paperwork for treatment of a patient or initiating a chart. May be required to lift up to 25 lbs often and occasionally lift up to 50 lbs in the work area. This job has vision requirements: close; distance; peripheral; depth perception; and ability to adjust focus as needed. Incumbent must be able to hear alarms on equipment; hear client calls; hear instructions from physicians and department staff; and, hear over head pages through a loudspeaker. The incumbent must be able to successfully use repetitive motion actions of bilateral feet; bilateral hands; hands grasping simple/light; hands grasping rarely firm/heavy; and, hands doing prolonged fine dexterity. Incumbent may occasionally need to push/pull objects; and, stoop, kneel, crouch, or crawl.
Mental:
Must be able to effectively communicate to the patient what specific information is needed, the reason for requesting such – information and be able to ascertain that it is accurate as possible. Consequences of obtaining inaccurate information may delay necessary medical treatment, delay billing process and cause unnecessary frustration and problems.
Environmental:
This job requires occasional exposure to the following environmental condition: wet, humid conditions(non-weather); work near moving mechanical parts; toxic or caustic chemicals; extreme cold (non-weather); extreme heat (non-weather); risk of electrical shock; risk of radiation; and, vibration. This job requires extensive exposure to environmental fumes or airborne particles. The typical noise level is moderate.
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NECESSARY QUALIFICATIONS
Education:
Must have a High School Diploma or GED
Certifications:
Must have and maintain a current Basic Life Support (BLS) certification by the American Heart Association (AHA), if none, obtain within three (3) months from date of hire.
Experience:
- Must have two (2) years of experience as a Patient Registration Technician.
- Must have one (1) year of experience working in a fast-paced office environment with the ability to manage and prioritize multiple assignments, completing tasks and demands while meeting tight deadlines.
- Experience with using an Electronic Health Record or similar system, specifically with registering patients.
Other Skills and Abilities:
A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas:
- Must have positive working relationship with others.
- Must have excellent customer service, personal and communication skills.
- Possession of high ethical standards and no history of complaints.
- Demonstrate the ability to complete special projects; the ability to meet departmental deadlines, analyze, research and troubleshoot.
- Reliable and dependable; reports to work as scheduled without excessive absences.
- Ability to work under conditions of frequent interruptions.
- Must be able to work independently and willingness to work flexible schedule.
- Must be proficient with typing and accurate spelling/grammar.
- Must have skills in the practical use of electronic systems to provide general clerical office support.
- Possess and employs an ability to communicate with patients and families during time of emotional and physical stress.
- Ability to handle sensitive and confidential information.
- Responds positively to supervision to enhance and improve work performance outcomes.
- Completion of and, above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job
- Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job
- Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job
- Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading, or incomplete information, as determined by TCRHCC
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