Access Services Associate II

Overview

CentraState Healthcare System, headquartered in Freehold, New Jersey is a leading non – profit healthcare delivery system in New Jersey. The System includes CentraState Medical Center a community-based hospital, an ambulatory campus, three senior living facilities and three free-standing community health pavilions, and a charitable foundation. As the 3rd largest employer in Monmouth County, CentraState Healthcare System continues to live up to its reputation of being a truly great place to work recently designated a Great Place to Work-Certified™ company.

Access services is comprised of Central Scheduling, Outpatient Registration, Admitting, Insurance Verification, Cashier and ED Registration and Reception. Some benchmarks that we are very proud of include:

• Average wait/registration time is 9 minutes, compared to the national average of 11 minutes
• 60% of the Access Services are nationally Certified Healthcare Access Associates
• Outpatient Registration/Scheduling and ED Registration have been in the 90th percentile for the last 10 years

This department works closely as a team as a part of our revenue cycle management division.

Responsibilities

Outpatient Access Services Associate:

• Registers each account in hospital registration system following all departmental procedures to ensure compliance with state and federal regulations.
• Obtains and determines the coordination of benefits and accurately inputs into computer software system following industry standards and departmental procedure.
• Clearly documents in computer system all communication with patients, family members, insurance companies and physicians. Documents any exceptions to standard procedure.
• Follows federal and state standards and complies with all regulations including accurate completion the MSP form and DOBI consent.
• Accurately utilizes Imaging system by scanning all paperwork into correct document and folder during registration, scheduling and verification process.
• Completes quality checks and reviews each registration and verification for correct information. Seeks assistance and plans corrective action.
• Handles departmental paperwork flow in a manner consistent with departmental policies and procedures.
• Periodically checks messages on the Outpatient Pre-registration line and follows up with patients as needed.
• Contacts patients scheduled for radiation oncology in a timely manner and completes accurate pre-registrations.
• Follows up on incoming faxes, taking any necessary action and filing them in appropriate folders, or bringing them to the lab or scheduling as needed.
• Answers incoming calls in a timely, professional and courteous manner, using name of department and identifying self as appropriate.
• Accurately enters all diagnosis codes into the registration system. Obtains patient signatures on ABN forms fro those charts with missing codes. Follows up with
• physician offices to obtain missing codes as needed.
• Accurately edits/completes all "paper only" registrations as time permits, updating all necessary information as needed. Scans all appropriate paperwork into the Siemens system and forwards completed packets to lab.
• Prints out Minor Surgery schedules and OR booking sheets as needed. Contacts patients to complete accurate preregistrations prior to procedure. Contacts OR scheduling department regarding any errors on the booking sheets, so that these can be corrected.

Emergency Department Access Services Associate:

• Completes bedside registration accurately and timely to ensure quality and privacy for positive clinical outcomes utilizing laptop computers.
• Registers each account in hospital registration system following all departmental procedures to ensure compliance with state and federal regulations.
• Obtains and determines the coordination of benefits and accurately inputs into computer software system following industry standards and departmental procedure.
• Clearly documents in computer system all communication with patients and/or family members. Documents any exceptions to standard procedure.
• Follows federal and state standards and complies with all regulatory guidelines.
• Completes quality checks and reviews each registration for correct information. Seeks assistance and plans corrective action.
• Handles departmental paperwork flow in a manner consistent with departmental policies and procedures.
• Acts as liaison between patients and/or families and clinical staff providing support as needed.
• Supports all policies pertaining to ED Registration. Is responsible for getting all consents including consents for minors, elderly, disabled or handicapped. Also responsible for starting the administrative consent process.
• Functions as a support part of the ED clinical team reacting urgently and appropriately to the needs of the ED clinical staff.
• Supports the Outpatient Registration department after hours and weekends.

Admitting Access Services Associate:

• Registers and admits each account in hospital registration system following all departmental procedures to ensure compliance with state and federal regulations.
• Obtains and determines the coordination of benefits and accurately inputs into computer software system following industry standards and departmental procedure.
• Clearly documents in computer system all communication with patients and/or family members. Documents any exceptions to standard procedure.
• Follows federal and state standards and complies with all regulatory guidelines.
• Completes quality checks and reviews each registration for correct information. Seeks assistance and plans corrective action.
• Handles departmental paperwork flow in a manner consistent with departmental policies and procedures.
• Operates the bed control desk in an efficient and effective manner understanding and administering policies and processes.
• Places patient in appropriate bed ensuring that resources are maximized and cohorting is appropropriate.
• Fosters good communication between the ED, clinical nurse units, Infection Control, Nurse Managers and physician offices to insure proper and timely placement of the patient.
• Clearly documents all necessary information on daily bed log.
• Accurately completes pre-registration of accounts while maintaining flow of accurate paperwork. Always strives towards department goal of preregistrations 3 weeks in advance.
• Works closely with Nursing Supervisors to ensure that patients are placed properly on the weekend shifts when limited resources are available.
• Handles all phases of the Admitting Department including pre-registration, bed control and patient intake.
• Contacts insurance companies after hours and on weekends via phone or web site to ensure proper precertification.
• Understands patient throughput and functions as a strong advocate to facilitate patient movement.
• Monitors hospital throughput by closely monitoring discharges and admissions in multiple software systems.

Insurance Verification Access Services Associate:

• Verifies each account in hospital registration system following all departmental procedures to ensure compliance with state and federal regulations.
• Obtains and determines the coordination of benefits and accurately inputs into computer software.
• Clearly documents in computer system all communication with patients, family embers, insurance companies and physicians.
• Completes quality checks and the review of each account for correct information.
• Re-verifies denied accounts. Resubmits and completes process for appeal.
• Coordinates with insurance companies, patients, physicians, and/or employers to verify coverage, to notify of services and to obtain pre-certification and/or referral
• requirements.
• Coordinates discussions with physicians and physician’s staff and patients on status of account and actions that will be taken.
• Facilitates discussion with patients and/or families on patient’s financial responsibilities.
• Investigates all self pay, workers compensation, no fault and secondary coverage.
• Accurately completes all forms required for a complete verification and sends to
• appropriate entity, Medicaid requirements to Self Pay Company, 21 day notices to No Fault Carriers, ABN to out patient departments.
• Works with physician offices to ensure accurate CPT coding for authorizations and maximum payment of contracted rates.

Qualifications

Education:

High School Diploma or Equivalent required or minimum 5 years’ experience in healthcare related clerical position in lieu of diploma

Work Experience:

Previous hospital experience in scheduling, registration or billing preferred

Required Knowledge and Skills:

Knowledge of medical terminology and strong customer service skills