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SalaryDEPARTMENT: SWM REGISTRATION
F ACILITY: Southwell Medical
WORK TYPE: Full Time
S HIFT: Daytime
HOURS:
SUMMARY:
The Patient Access Specialist is generally the first point of contact for patients entering the facility or scheduling appointments. The Patient Access Specialists role includes scheduling physician ordered exams, obtaining pre-certification/prior-authorization (as required), collecting patient responsibilities, and registering patients system-wide.
RESPONSIBILITIES:
* Obtain and verify patient demographics, guarantor and insurance information for new or established patients either by telephone or face to face for inpatient and outpatient population system-wide in accordance with departmental policy.
- Create a patient/case record in the ADT registration system in accordance with established policy and procedures for inpatient, ambulatory surgery, non-patient laboratory, radiology and/or other diagnostic ancillary tests/services.
- Answer telephones and transfer calls to appropriate personnel and departments.
- Schedule outpatient hospital exams system-wide as ordered by physicians in an accurate and timely manner, in accordance with department standards and protocols.
- Analyze insurance information/reason for admission or encounter to determine pre-certification and/or pre-authorization requirements.
- Contact insurance carriers to obtain pre-certification and pre-authorization numbers. Contact patients/providers offices as needed to verify/obtain data.
- Ensure the patient record is updated with accurate information and the insurance record reflects all appropriate insurance, appropriately prioritized. (coordination of benefits)
- Ensure all registrations are completed prior to discharge.
- Ensure all deductibles and co-payments are collected in accordance with insurance benefits and departmental policy for inpatient and outpatient population
- Ensure patients are apprised of advanced beneficiary notice, as appropriate and in accordance with Medicare Medical Review Policies.
- Provide cross coverage to other Patient Access locations as needed.
- Assist in other projects as needed and as assigned by department leadership.
- Promote excellent customer service to internal and external customers.
- Providing cost estimates for all required patients system-wide to ensure compiance with the Good Faith Estimate Act.
- Maintining productivity standards as outlined by leadership.
- Adhearing to Point of Service (POS) collections standards as outlined by leadership.
- Verifies that the minimum data set for all orders is obtained prior to scheduling/registration
- Scanning in of valid forms of ID, Insurance card, and Physician Order
- Informs patient of Consent for Treatment, Patient Bill of Rights, Joint Privacy Practice, and other required admission forms at the point of service.
- Keeps abreast of all pertinent federal, state and facility regulations, laws and policies as they presently exist and as they change or are modified.
- Understands and adheres to compliance standards as they appear in the Corporate Compliance Policy, Code of Conduct, and Conflicts of Interest Policy.
- Demonstrates age-specific skills as required by position.
- Offers suggestions on ways to improve operations of department and reduce costs.
- Attends all mandatory education programs.
- Improves self-knowledge through voluntarily attending continuing education/certification classes.
- Maintains required competency levels as identified in written exams, skills checklists, skills labs, annual safety and health requirements as well as service excellence education hours requirements.
- Willing to cross-train in order to better assist co-workers and to provide maximum efficiency in department.
- Volunteers/participates on hospital committees, functions, and department projects.
- Manages resources effectively.
- Reports equipment in need of repair in order to extend life of equipment.
- Makes good use of time so as to not create needless overtime.
EDUCATION:
* High School Diploma or Equivalent
*GED
CREDENTIALS:
OTHER INFORMATION:
One (1) year of applicable medical office/hospital based customer service experience preferred.
CHAA certification preferred.
CHAA certification preferred.
COMPETENCIES & SKILLS:
* Takes personal responsibility for the quality and timeliness of work, and achieves results with little oversight.
- Adapts to changing business needs, conditions, and work responsibilities and works with a variety of situations, individuals, groups, and varying customer needs.
- Diligently attends to details and pursues quality in accomplishing tasks.
- Basic computer skills
- Cerner
- Possesses a mature and justified self-belief in one’s ability to do the job and the conveyance of that belief.
- Diplomatically handles challenging or tense interpersonal situations.
- Works together with others to achieve a common goal.
- Possess the ability to think clearly and rationally, understanding the logical connection between ideas.
- Provides excellent service to internal and external customers.
- Is reliable and trustworthy while performing work in a consistent and timely manner.
- Electronic medical record documentation
- Electronic medical record software
- Earns others’ trust and respect through consistent honesty and transparency in all interactions.
- Openness to different and new ways of doing things and willingness to modify one’s preferred way of doing things.
- Correctly interprets and follows instructions.
- Healthcare procedure scheduling
- Displays an ongoing commitment to learning and self-improvement and makes an effort to acquire new knowledge or skills for work.
- Understands and learns from what others say.
- MS Office
- Conveys ideas and facts orally using language the audience will best understand.
- Manages time, energy and workspace well and is able to accomplish assigned tasks successfully.
- Phone skills
- Resolves difficult or complicated challenges.
- Grasps the meaning of written information and applies it to work situations.
- Builds constructive working relationships characterized by a high level of acceptance, cooperation, and mutual respect.
- Does what he/she commits to doing.
- Has ability to cope with and rise to inevitable challenges, problems and set-backs.
- Focuses on results and desired outcomes and how best to achieve them in order to get the job done.
- Identifies, assesses, and manages risk while striving to attain objectives.
- Manages own time, priorities, and resources to achieve goals.
- Maintains composure in highly stressful or adverse situations.
- Promotes cooperation and commitment within a team to achieve goals and deliverables.
- Ensures that work is complete and accurate and follows up with others to ensure that agreements and commitments have been fulfilled.
- Helps create a work environment that embraces and appreciates diversity.
- Conveys ideas and facts in writing using language the reader will best understand.
Southwell/Tift Regional Health System, Inc. is an Equal Opportunity Employer.
