Patient Access Representative - CRMC

POSITION SUMMARY

Under the direction of the HIM Director or Designee, the Patient Access Representative is responsible to facilitate 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 to 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.

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.
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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.