Patient Access Clerk

DISTINGUISHING FEATURES OF THE CLASS: The employees of this class perform a wide variety of duties and are responsible for helping patients gain access to medical treatment.  The patient access clerk processes the information required for admittance, dismissal and insurance billing and should have a basic understanding of medical terminology.  The incumbent must be able to communicate well with members of the public and accurately record data. Does related work as required.

TYPICAL WORK ACTIVITIES:

• Greets patients and their caregivers and records pertinent information into a computer database including patient’s insurance or managed care plans;
• Confirms patient’s eligibility for service, insuring that required referrals have been received, and captures authorization and co-pay information;
• Obtains pre-approval for treatment if needed;
• Relays information between patients and other staff members, and provides them with updates as needed;
• Keeps paper and electronic medical records, and updates these records as needed;
• Provides information to insurance companies in order to assist with billing;
• Assists patients during checkout, and ensures they have post-treatment instructions if required;
• Assists patients in making follow-up appointments if needed;
• Answers telephone and takes messages or responds to inquiries or routine questions;
• Refers individuals to outside agencies when unable to meet their needs;
• Calculates payment information, accepts funds, and credits accounts accordingly;
• Participates in performance improvement activities as directed;
• Opens, stamps, and distributes mail and processes outgoing mail;
• Operates calculator, computer and other related office equipment;
• Maintains quality results by following standards;
• Maintains work operations by following policies and procedures and reporting compliance issues to the appropriate personnel;
• Reports any patient care or billing complaints to the Compliance Officer;
• Serves as receptionist and greets clients and/or visitors;
• Performs miscellaneous clerical duties including answering phones, correspondence, photocopying, daily mail, and ordering office supplies.

FULL PERFORMANCE KNOWLEDGE, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS

Working knowledge of medical terminology; ability to establish and maintain satisfactory relationships with others; ability to maintain accurate records and prepare simple reports; ability to operate a personal computer and utilize software programs; ability to maintain confidentiality, ability to remain calm, even under the most stressful of situation; clerical aptitude; communicates well, both orally and in writing; physical condition commensurate with the demands of the position.

MINIMUM QUALIFICATIONS:  Either:

1. One year of clerical or patient contact work experience in a health facility, clinic, physician’s office or similar setting; or
2. Possession of a technical certificate in medical office administration or a similar discipline
3. Completion of a BOCES or vocational school program in a health services field; or
4. An equivalent combination of experience and training as defined by the limits of (A) and (B) above.