Patient Access Rep 1

Advocate Health
United States, Illinois, Elgin
Nov 12, 2024
Major Responsibilities: Performance of routine secretarial and clerical services in support of department activities. This may include: 3)Contacts physicians to obtain and clarify orders. Performs follow-up of verbal orders. Performs standing order review and creates accounts as appropriate. 4)Open, sort, and route mail to the appropriate individuals. 5)Greets patients and directs visitors. Answers multiple incoming telephone lines, accurately determining the appropriate recipient of the call or message and referring them promptly and appropriately. 6)Orders forms and office supplies as needed 7)Monitors and maintains various work queues and issue reports, and/or performs special projects as assigned. 1)Receives, properly responds to, or redirects telephone, electronic, and in-person inquiries from patients, payers, physician and their staff, internal departments, external organizations and other persons or entities. Obtains, receives and documents accurate and thorough information when taking messages or redirects calls appropriately. Schedules appointments as applicable. 2)Monitors the receipt and indexing of faxes received through the electronic storage software, fax scanning system. Performs maintenance on scanned faxes, including interpreting physician orders; and naming, sorting and filing of faxes. Medical Record Services: Upholds standards for accurate and timely medical records 2)Creates and maintains patient records and files within the department. 3)Prepares charts for scanning, ensuring that all pages are present, completed and labelled with patient identification. Follows up with appropriate individual if documentation is absent or incomplete 1)Scans charts, ensuring that all pages are legible, upright, scanned to the correct account. Indexes scanned pages to correct document type. Accurately collects and analyzes all required demographic, insurance/financial and clinical data necessary to register/admit patients from all payer classes. 3)Understands and follows all government, managed care and commercial insurance plan rules as they relate to patient access; and ensures accounts are in order for timely billing and collection. 4)Collects and records accurate and thorough patient, guarantor, insured and insurance information when registering patients' accounts 5)Interprets and validates physician orders for service, uses appropriate accommodation and service codes; and establishes account parameters to ensure revenue is properly recorded and accurate bills are produced 6)Accurately generates, assembles and processes all required forms, documents and reports including face sheets, labels, and medical record forms, and other special documents. Produces and distributes these on a timely basis to both internal and external parties. 7)Using insurance eligibility software, validates demographic information and assures patients are eligible for service provided. 8)Recognizes communication obstacles for patients with loss of hearing and/or sight, and those that have trouble in reading, writing and understanding the English language. Responds appropriately to patients' communication needs, secures interpreter or other necessary assistance to ensure customer comprehension. 9)Appropriately explains, secures, and witnesses all signatures required to provide medical treatment, assign insurance benefits, release information, establish financial responsibility and meet other internal regulatory, or payer requirements. 1)Using approved identification standards, positively identifies the patient and ensures assignment of a unique medical record number 2)Completes the Medicare Questionnaire for all Medicare patients. Performs revenue cycle activities that maximizes revenue, prevent payment denials, increase cash collections and assures appropriate financial disposition of account balances. 2)Accurately posts payments and adjustments to the patients' account. Requests and accepts payments, generates receipts for funds received and maintains necessary records of payment transactions. Utilizes automated systems to process credit and debit card transactions. Ensures payments are secured; and deposits and cash drawers are balanced and turned over to appropriate associates. 3)Initiates electronic and/or telephone inquires to insurance payers/claim administrators. Provides information and secures responses that confirm eligibility for the third-party benefits and the level of benefits available. 4)Identifies and obtains needed authorizations, referrals and service approvals from physicians, insurance companies and/or medical management companies. 5)Explains to patients insurance benefits, patient balances and provides information to ensure they understand the policies that govern the revenue cycle and the processes that will be followed. 6)Explains various payment options to the patient or responsible party and negotiates acceptable resolution of expected self pay balances. Explains the charity care process and provides application packet. Updates system to record charity application was given to patient/responsible party. 7)Using compliance checker software, screens physician orders against medical necessity criteria. Follows procedures related to obtaining additional diagnosis from physicians and initiating the Medicare Advance Beneficiary Notice of Noncoverage to patients 8)Logs all patient visits, entering data not available at the time of registration (discharge time, disposition, diagnosis, etc.) 9)Ensures insurance is updated, deposits and co-pays are collected and financial applications provided when appropriate to patient's situations. 1)Inputs and checks charges for accuracy of charges. Audits charges identified by the clinical staff. Makes corrections as needed. Runs daily log report to ensure that all registered patients have been charged and logged. Demonstrates professional behavior, follows customer service expectations and participates as a collaborative member of the patient care team. 4)Communicates pertinent information and any information regarding delays with patients and families. Disseminates accurate and complete information to all inquiries regarding patient care, hours, services, programs, etc. 5)Serves as a positive role model for peers and staff. Demonstrates support of the organization, department and staff through all words and actions. Displays pleasant personality and positively contributes to department morale. 6)Anticipates the needs of the department and others. Modifies work schedule to cover vacancies, assists on special projects or meet work deadlines. 7)Observes guidelines concerning dress, display of name badge and presents an appearance appropriate to the work environment. Assists in keeping environment neat and orderly. 8)Demonstrates initiative by identifying opportunities for improvement and works collaboratively with the patient care team to develop and implement solutions. 9)Attends department meetings, classroom education and independantly completes online learning in a timely manner. Participates in opportunities to grow and develop in position and improve the department. 10)Participates in problem solving issues addressing patients, department operations, quality assurance procedures, interdepartmental relations, and employee morale. 1)Provides competent, appropriate and timely service to all customer groups. Consistently practices good internal customer service, remembering that peers, patients and physicians are customers. 2)Greets everyone appropriately (utilizes good eye contact, smiles, verbal acknowledgement). Introduces self and explains role. 3)Supports the team environment and collaborates with team members. Works well as a team player. Demonstrates committment to providing quality and safe patient care by participating in performance / process improvement and adherence to all accepted safety standards and practices to ensure patient safety and quality patient care 1)Utilizes preventative measures and maintains compliance with established safety standards to protect patients and staff at all times. Identifies potential and actual problems which put people at risk for injury. 2)Assists in the development and implementation of improvement processes as applicable. 3)Participates in performance improvement activities. Gathers, documents and reports data as necessary. Demonstrates committment to quality by achieving compliance on primary responsibilities and expectations. 4)Adheres to all policies, procedures and regulatory expectations. Understands and follows HIPAA, other regulations and standard, hospital and departmental policies and procedures. Participates in educational opportunities to increase professional competence. Provides instruction and orientation to secretaries as needed. 4)Provides direction and instruction to other secretaries/registrars in need of assistance with specific procedures 5)Recognizes own needs for continued learning and assumes responsibility for own continuing education. 1)If applicable, as a preceptor, collaborates with others to individualize the orientation plan for new departmental employees. 2)Presents or coordinates inservices for staff. 3)Independently completes mandatory annual educational requirements and follows through and meets deadlines for other competencies. Education/Experience Required: HS diploma or equivalent. 2 years experience preferrably in a health care/customer service position. Previous healthcare experience preferred. Knowledge, Skills & Abilities Required: Effective organizational and prioritization skills. Computer literate. Types at 35 wpm preferred. Knowledge of office equipment. Effective interpersonal and customer service skills N/A Physicial Requirements and Working Conditions: Ability to work in a fast-paced environment with established time constraints and difficult situations Must be able to make independent professional decisions pertaining to high quality patient care Must possess visual acuity and manual dexterity to perform computer data entry and other clerical aspects of job. May walk, sit, stand, bend, stoop, twist and reach in conjunction with the job requirements. Must be able to function with minimal assistance in performing job activities Must be conscientious in practicing high quality patient care Must be able to work weekends, holidays, rotating shifts and occassionally at other off-site locations. May be exposed to a variety of illness and medical conditions. This position can recognize needs and behaviors of the following age groups: pediatric (newborn, toddler, school-age), adolescent, adult, older adult. Evidence of this can be shown by recognizing levels of development and modifying approach and exhibiting communication skills necessary to interpret age specific responses. If position has direct patient care or direct patient contact the following lifting requirement supersedes any previous lifting requirement effective 06/01/2015. Ability to lift up to 35 pounds without assistance. For patient lifts of over 35 pounds, or when patient is unable to assist with the lift, patient handling equipment is expected to be used, with at least one other associate, when available. Unique patient lifting/movement situations will be assessed on a case-by-case basis. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.