The posting
EQUAL EMPLOYMENT OPPORTUNITY
- Race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate shall not be a factor in employment for this position. Due to the nature of hospital services, it may become necessary to work extended hours.
POSITION SUMMARY
- Responsible for scheduling, insurance verification, prior authorization validation and registering patient accounts with a focus on hospital reimbursement. Interpret and ensure compliance with payer guidelines for accurate input. Works in tandem with the clinical staff, checks vitals, med runner and assists with patient needs. Assist patients with drug replacement/assistance programs and insurance inquiries. Assist to resolve issues and/or concerns.
POSITION SUPERVISORY RESPONSIBILITIES
- Reports To:
- Patient Access Manager/Outpatient Clinical Service Line Director
- Supervises:
- None
POSITION REQUIREMENTS
- Minimum Education
- High School or equivalent.
- Minimum Work Experience
- One year's experience in a hospital, insurance or office environment preferred. Experience with automated systems required. Prior experience involving public contact. Clinical experience.
- Required Licenses/Certifications
- None
- Required Skills, Knowledge, and Abilities
- Ability to interpret and generate written correspondence utilizing proper grammar, spelling and composition skills. Knowledge of Payer guidelines required. Computer knowledge required. Ability to operate office equipment, such as copy machines, fax machine and printers. Must be able to work independently with minimal supervision. Good communication skills essential. Ability to pass basic job related competencies.
- Preferred Qualification
- Medical terminology preferred.
PHYSICAL REQUIREMENTS
- "Light work, exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and negligible amount of force constantly to move objects." Involves sitting for long periods of time. Occasionally requires standing, walking, bending, stooping, reaching, lifting, pushing and pulling. Requires near and midrange vision, talking, hearing, repetitive movement of wrists, hands and fingers. Requires viewing computer screens for extended periods. The incumbent works in a good environment under clean working conditions; one or more disagreeable elements may be present to a small degree from time to time. There is potential for exposure to contagious diseases from patient contact but these will be minimal if proper safety precautions are taken.
QUALITY BEHAVIORAL EXPECTATIONS
Generally and in all job specific duties: Uses critical thinking skills to determine evidence based solutions. Systematically gathers and reviews pertinent information to prevent errors (PDCA -- Plan, Do, Check, Act). Pursues individual or team learning and growth opportunities to continually build skills. Understands and abides by all safety regulations.
SERVICE EXCELLENCE BEHAVIORAL EXPECTATIONS
- Generally and in all job specific duties: Maintains patient confidentiality. Rounds regularly with patients, direct reports and/or customers. Uses telephone and elevator etiquette. Acts as an employee ambassador. Committed to know hospital service lines and shows pride in our organization. Uses AIDET when dealing with internal or external customers.
FISCAL RESPONSIBILITY BEHAVIORAL EXPECTATIONS
- Generally and in all job specific duties: Takes responsibility for solving problems. Treats company resources responsibly. Performs work functions timely and accurately. Respects our environment; keeps public areas neat and clean and returns supplies to the appropriate areas.
PEOPLE BEHAVIORAL EXPECTATIONS
Generally and in all job specific duties: Supports the team through good attendance. Maintains a professional appearance. Creates a positive team environment; flexible and supportive setting an example of cooperation. Uses meaningful communication; provides honest feedback that is valuable and not critical and discourages negative talk and gossip. Respect co-workers.
JOB SPECIFIC FUNCTIONS
- Demonstrates an understanding of and adherence to the HMHD Compliance Plan.
- Conduct reflects HMHD's values and a commitment to HMHD's Code of Conduct.
- Attends the required corporate integrity and compliance training and education programs.
- Demonstrates proficiency in understanding the materials presented during the corporate integrity and compliance training and education program.
- Complies with all HIPAA standards.
- Answers phones and greets patients in a pleasant, professional manner.
- Responsible for the scheduling of patients and maintaining the schedule on a daily basis for multiple service lines.
- Performs a total assessment of patient accounts to determine verification of insurance and what benefits exist.
- Enters complete and thorough benefit information to include obtaining required authorizations and patient estimates.
- Interpret and ensure compliance with payer guidelines for accurate input. Must maintain a minimal error rate.
- Screens patient accounts and takes appropriate action when benefits are exhausted or certification is not approved. Immediately refers to the Financial Counselor or Eligibility vendor.
- Notifies patient when issues with insurance company exist or, if possible, when there will be an unexpected patient balance.
- Assists patients with applying for Drug Replacement/Assistance programs.
- Thorough in verifying demographic information and discussing financial obligations during the registration process.
- Explains pertinent documents and hospital policies.
- Works in tandem with the financial counselors, personnel from other departments, physician's and their office staff.
- Handles patient and insurance inquiries. Assist to resolve issues and/or concerns.
- Responsible for maintaining clinical competencies for checking vitals and any other clinical responsibilities.
- Serves as a runner to pick up medicine and other supplies.
- Resolve issues and/or concerns amicably in a timely manner. Involves PFS or Nursing Leaders when needed.
- Promote and demonstrate excellent customer service at all times with internal and external customers to include patients, family members, physicians, co-workers and all other customers.
- Communicates effectively and expresses ideas clearly, actively listens and follows appropriate channels of communication.
- Adaptable and responsive to change.
- Uses time clock accurately and is punctual on a consistent basis.
- Demonstrates a positive attitude in all assigned task and towards others.
- Follows "Call-In" policy by notifying PFS Leader of absence. Absences during evaluation period: 0-6 Occurrences = Meets Requirements. 7 or more Occurrences = Does not meet requirements.
- Adheres to hospital and department dress code. Maintains a professional appearance at all times.
- Consistently contributes to the achievement of excellence in healthcare through the quality and caring values of the mission and vision of Hunt Memorial Hospital District.
- Attends scheduled departmental meetings.
- Perform special duties and projects as assigned.
