Patient Access Specialist

Untitled Document

COMMUNITY MEDICAL CENTER, INC.

JOB DESCRIPTION

DEPARTMENT: Patient Access Department

JOB TITLE: Patient Access Specialist

I. JOB SUMMARY: Responsible for the performance of all registration/pre-registration functions at all Patient Access intake points of entry. Responsible for insurance verification functions. Responsible for the identification and referral of patients who might have financial difficulty. Responsible for Point of Service cash collection per CMC guidelines.

II. JOB RELATIONSHIPS:

A. Responsible to: Department Manager

B. Workers Supervised: None

C. Interrelationships: Patients, relatives, insurance, payers, visitors, physicians, co-workers and other hospital personnel.

III. DUTIES & RESPONSIBILITIES:

A. Essential Job Duties:

 

1. Register all patient types, including patient’s information such as demographics, insurance/coverage and clinical information.
   • Emergency
   • Acute Care: Med/Surg/OB/
   • Rehabilitation Service
   • Outpatient Surgery/Procedures
   • Outpatient Ancillaries
   • “Non patients” – specimens only
2. Assures document retention as required by CMC. Scanning, retrieving and editing and patient identification
3. Pre-Register all designated patient types including such information as demographics, insurance/coverage and clinical information.
4. Determine patient’s eligibility, coverage and insurance limitations. Understand and be able to translate coverage issues such that patient is fully informed. Skill includes:
   • i. Online verification
   • ii. Direct verification through phone/fax
5. Identify patient’s potential financial liability for a specific service. Identify patients at risk for inability to meet financial liability. Make a referral to an appropriate agency/person. Ability to explain overview of options available to patients/families.
6. Exhibits an ability to address the issue of point of service cash collection and to actually collect cash funds as described by CMC financial goals. Comply with cash handling procedures.
7. Understand and comply with all regulatory restrictions and imperatives within a Registration setting.
   • EMTALA (Emergency Treatment)
   • HIPAA (Privacy)
   • MSP (Medicare as Secondary Payor)
   • Advanced Directives
   • v. Medicare – Advanced Beneficiary Notice
8. Participate in a strong performance management approach by:

   i. Performing to the standards set by the department for

   1. Productivity

   2. Quality

   3. Accuracy

   ii. Participating in training and cross training opportunities

   iii. Demonstrating skill in basic audit activities

   iv. Complying with documentation requirements of the department

   v. When requested, assists other departments which perform registration responsibilities

9. Works as a strong team member in a dynamic, patient focused, fast paced environment.

10. Possesses and employs an ability to communicate with patients and families during time of emotional and physical stress.

11. Willingly accepts other responsibilities as requested. Demonstrates ability work and make decisions without supervision present.

    Note: All Patient Access Specialists will be expected to be fully cross trained in all major job functions. The actual amount of time dedicated to a task or emphasis on an assignment will vary based on registration location, time of day and specific shift.

B. Marginal Job Duties:

- Ability to work independently.

- Ability to prioritize tasks.

- Quick decision making ability.

- Effective written and verbal communication skills.

- Effective telephone skills.

- Ability to multitask effectively and completing assignments in a timely manner.

IV. SERVICE EXCELLENCE STANDARDS:

1. 1. Internal Service: Serve and care for our employees as we would for our patients and guests. Treat our colleagues as professionals through courtesy, honesty and respect. Encourage other people’s work; praise whenever possible. Make new staff members feel welcome.
2. 10-Foot Circle: Engage and acknowledge everyone who comes into your circle of influence. Smile and introduce yourself when appropriate. When riding the elevators, initiate conversation and hold the door open for others.
3. Positive Image: Present a positive image through friendly body language, facial expression and appearance. Be clean and professional. Follow dress code policies and wear your identification badge correctly at all times.
4. Phone Image: Create a welcoming atmosphere by answering the phone in three rings or less with a personal greeting. Identify your department and yourself, and then ask, “How may I help you?” Know how to operate the telephones in your area. Provide the correct number before transferring a call. Get the caller’s permission before putting them on hold and thank the caller for holding.
5. Personal Connection: Find ways to create relationships with our patients and guests. Use their names in every interaction. Be respectful of patients and make sure that patient information is kept confidential.
6. No-Passing Zone: Anticipate and help patients and guests with their needs. Listen to our patients and guests. Be courteous. Speak clearly and avoid jargon. When you pass a patient or guest off to someone else, take personal responsibility to follow through. Educate families about procedures and provide a comfortable atmosphere for waiting.
7. Make a Point: Escort our patients and guests to their destination, whenever possible, or take them part of the way there. Avoid pointing.
8. Personal Accountability:Take pride in this organization as if you own it. Act with honesty and sincerity in all interactions. Accept the responsibilities of your job. Adhere to policies and procedures. Never discuss patients and their care in public areas or with your family and friends. Live the values of this organization. Hold each other accountable to follow the service excellence standards. You are CMC!
9. Always Strive to Exceed: Find ways to say “yes” to our patients and guests. Give options and think of ways you can exceed expectations. Use service recovery as a way to create an advocate. Thank our patients and guests for choosing Community Medical Center.

V. QUALIFICATIONS:

A. Education: High School diploma or the equivalent.

B. Licensures, Certifications, Registrations: None.

C. Job Knowledge:

1. Clerical skills.
2. Basic telephone skills.
3. Keyboard proficiency.
4. Knowledge of computer and basic functions
5. Medical terminology.
6. Knowledge/Ability to perform Microsoft applications: Word/Excel/Power Point

VI. PHYSICAL DEMAND LEVEL:

- Frequent typing on keyboard (50 wpm).

- Prolong sitting.