Patient Access Clerk

Description

POSITION TITLE: Patient Access Representative

DEPARTMENT: Patient Access/Admissions

EMPLOYEE REPORTS TO: HIM Director or Designee

SUPERVISES: N/A

FLSA STATUS: Non-Exempt or Exempt

EMPLOYMENT STATUS: Full-time, Part-time, or Per Diem

SECTION I – Description of Position

This job description is a record of the essential functions of the listed job. The job description provides the employee, CEO, Human Resources, applicants, and other agencies with a clear understanding of the job, where it fits into the organization, and the skill and work requirements in relation to other jobs. Jobs are always changing to some degree, and the existence of the approved job description is not intended to limit normal change and growth. The facility will make reasonable accommodation to otherwise qualified individuals who are capable of performing the essential functions of the job with or without reasonable accommodation.

POPULATION SERVED

The position does not involve direct patient care for a population of patients ages 18 and

older. Age specific experience and/or special training and/or expertise are not required to

serve this population.

POSITION SUMMARY

Under the direction of the HIM Director or Designee, the Patient Access Representative is

responsible for facilitating the patient registration flow, including such activities as point of

service patient identification; gathering demographic information; securing financial, third-party, and sponsorship data; obtaining required signatures and documents needed for

compliance and appropriately collecting co-payment and reconciling cash. The Patient

Access Clerk admits patients by gathering and recording physician, patient, and payment

responsibility information; answering questions; providing hospital and hospital services

information. Attends telephone inquiries from patients, Case Managers, Physicians, Social

Workers and outside agencies. Processes financial clearance prior to admissions by

contacting insurance carrier, thereby assuring payment before patients are

admitted. Assists in maintaining the Admissions Department on a daily basis.

JOB RESPONSIBILITIES:

•  Pre-admits patients by receiving bookings from referring facilities and or physicians; confirming admitting privileges of physicians; interviewing patients; entering patient information to pre-admissions database.
•  Provides patients with information by explaining hospital admission policies and forms, time of admission, room selection, TV, visiting hours, telephone availability, cell phone restrictions, answering inquiries.
•  Secures payments by screening insurance information; identifying patients requiring pre-admission approvals from third-party payers; verifying approvals; notifying patient accounts department of self-paying admissions.
•  May prepare admission folders by gathering admission paperwork for scheduled patients.
•  Greets and receives patients to be admitted by conducting personal interviews; entering demographic and insurance information; confirming pre-admission information; obtaining signatures on legal consents and insurance forms; receiving payment and issuing receipts; distributing patient information literature.
•  Verifies patient identify by checking identification; preparing and placing identification band on patient.* Ensures patient's arrival to hospital room and or testing area by assigning patient beds; notifying nursing unit of patient's arrival; calling volunteer to transport the patient to the assigned area.
•  Provides information to the public by answering admitting procedure, hospital regulation and service inquiries of patients and the public, referring inquiries.
•  Serves and protects the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and DNV standards.
•  Accomplishes individual and team goals and objectives established by supervisor based on prior performance evaluation.
•  Consistently demonstrates commitment to customer service excellence in all interactions with patients, family members, visitors and other staff that are consistent with the Customer Service performance standards.
•  Continually participates in building and maintaining positive working relationships through effective communication, performance improvement and teamwork efforts.
•  Demonstrates the ability to clearly and effectively communicate (to include reading, writing, and speaking) to all patients, family members, visitors and other staff members with the expectation that each employee, within the context of their specific job duties, can read, interpret, understand, and communicate clearly and effectively in order to ensure proper understanding, all written/verbal communication are followed and information is shared appropriately.
•  Accomplishes admissions and hospital mission by completing related results as needed.
•  Maintain updated bed ability and enters patient admitting information on to Daily Census and routes printed copy to clinical departments via fax and Share Point.
•  Maintain a professional appearance as outlined in the Coalinga Regional Medical Center Appearance Policy and project a business-like decorum at all times with patients, visitors, physicians, clinical staff and team.
•  Alerts necessary departments of admission and any special requirements via fax, Share Point and electronic health record.
•  May assist in obtaining signatures for consents, etc.
•  Answer phones: emails and perform any other duties pertaining to the Admissions Department.

Requirements

POSITION QUALIFICATIONS

High school graduate or equivalent, and one (1) year customer service experience

preferred in a Healthcare setting. Insurance verification experience and/or registration is

preferred. Must possess good oral, written and interpersonal communication skills.

Other desired qualifications:

•  Demonstrates ability to consistently achieve a high level of accuracy and attention to detail
•  Demonstrates perseverance, concentration, resourcefulness and good reasoning ability
•  Demonstrates ability to cope with interruptions, remember pertinent guidelines, policies and procedures
•  Ability to organize and prioritize work
•  Ability to work as a team member
•  Some knowledge of office computer software packages, including spreadsheets and word processing
•  Enhances organization reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments

DEMANDS AND CHARACTERISTICS OF WORK, EQUIPMENT USAGE, AND WORK

ENVIRONMENT

PERCENTAGE OF WORK TIME

• Standing/Walking -34-66%
• Sitting -34-66%
• Twisting -34-66%
• Lifting/Carrying -34-66%
• Pushing/Pulling -34-66%
• Climbing (Ascending/descending) -1-33%
• Bending/Stooping -34-66%
• Using arm muscles frequently or for extended periods -34-66%
• Using leg muscles frequently or for extended periods -34-66%
• Using back muscles frequently or for extended periods -34-66%

LIFTING REQUIREMENTS

• 2-10 Pounds -34-66%
• 11-20 Pounds -34-66%
• 21-30 Pounds -1-33%
• 31-40 Pounds -1-33%
• 41-50 Pounds -1-33%
• 51 Pounds or More -1-33%

WORKING ENVIRONMENT

• Working in hot, cold, wet surroundings -67-100%
• Working outdoors -34-66%
• Working with or near chemicals -1-33%
• Working near radiation sources -1-33%
• Potential exposure to communicable diseases -1-33%
• Working with hazardous waste materials -1-33%
• Utilizing essential upgraded or adaptive equipment as industry standards require -1-33%
• Using hand tools -1-33%
• Potential for cuts and bruises -1-33%
• Driving company or personal vehicle -34-66%

EXCHANGE OF IDEAS

• Ability to express or exchange ideas -67-100%
• Ability to understand communication of others with or without adaptive devices -67-100%
• Ability to perform secondary level math -67-100%
• Ability to read at a secondary level -67-100%

WORKPLACE BEHAVIORS

I. RESULTS ORIENTATION – Meets current objectives and positions the organization

for future growth. Completes daily tasks and assignments and processes large

volumes of work associated with the operation of the department.

II. SOCIAL SENSITIVITY - Builds positive relationships based on respect for others.

Demonstrates a helpful, positive attitude. Maintains effective communication with

peers, medical staff, patients, visitors, and families.

III. QUALITY OUTCOMES – Meets and exceeds expectations of internal and external

customers. All organizational and departmental standards regarding quality of

performance are met. Demonstrates a strong commitment to confidentiality.

Participates in quality improvement programs as directed.

IV. SAFE WORKING ENVIRONMENT – Demonstrates an awareness of and adherence

to safety and legal requirements established at the facility with an emphasis on

maintaining a safe environment for all persons working in the facility.

• Accident/Injury Reporting – Reports any accidents, injuries, and unsafe equipment and conditions to supervisor by the end of the shift and reports any pre-existing conditions as identified by the ADA.
• Unsafe Conditions – Immediately reports and corrects, if possible, unsafe conditions or equipment.
• Workplace Standards – Compiles with relevant regulations, standards and policies governing safe workplace environment (OSHA, Accreditation, etc.)
• Safety Techniques – Maintains current knowledge of all aspects of the facility’s safety program by attending safety-related training as mandated upon hire and thereafter as required by facility.
• Modified Work – Accepts modified work assignments after receiving the physician’s release to return to work following an accident/ injury.
• Follows Prescribed/Recommended Treatment – Follows the prescribed/recommended treatment given by treating physician(s) after an accident/injury.

V. EDUCATION – Participates in required in-services and educational programs on an

ongoing basis.

VI. ATTENDANCE AND PUNCTUALITY – Follows all facility guidelines outlining

standards of attendance and punctuality. Responsible for reporting to and completing

work at assigned times.

UNIVERSAL PRECAUTIONS

Universal precautions will be observed in order to prevent contact with blood or other

potentially infectious materials. Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials. All blood or other potentially infectious materials will be considered infectious regardless of the status. The category shown below is designed to communicate the risk of exposure for this particular position.

Category II

Tasks involve no contact with moist body substances, non-intact skin or mucous

membranes; however, employment may require performing unplanned Category I tasks

(i.e. Tasks that involve light contact with moist body substances, non-intact skin or

mucous membranes. Department procedures define and require use of minimum

protective measures to perform the task). Appropriate protective measures are readily

available.