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Patient Access Representative II

2 months ago

Tomah, United States TOMAH HEALTH Full time

POSITION DETAILS

Full-time with benefits; 80 hours per two week pay period, primarily Monday through Friday, could be 8 or 12 hour shifts; must be flexible to meet the scheduling demands of Patient Access and Scheduling. This position will not have an absolute set schedule due to the flexibility requirement of filling open shifts and will be required to fill in on weekends and holidays if needed.

JOB SUMMARY

The Patient Access Representative (PAR) II is the fully cross-functional level and role of the Patient Access and Scheduling services. The PAR II is highly skilled and works in both patient access and scheduling areas but not limited to hospital greeter, hospital switchboard, outpatient registration, emergency department registration, insurance verification and patient scheduling. The PAR II is responsible for providing scheduling support for various departments of the hospital, providing excellent customer service on the phone and in person; facilitates patient admission/registration flow, including such activities as patient identification; gathering demographic information; securing third party, financial and guarantor information, obtaining required signatures and documents; and entering patient data into the hospital information system.

This position is considered a crucial link between the patient and the services provided by clinical and support staff of the hospital. The PAR II is the first point of contact at Tomah Health and serves the patient, patient family and all other visitors in such a manner as to make the visit as comfortable and pleasant as possible.

MAJOR JOB FUNCTION

  1. Greets patients and visitors and responds to routine requests for information. Answers phone calls, screens calls and takes messages as needed.
  2. Registers patients; obtains demographic and insurance information; verifies insurance coverage, collects copays, deductibles and previous balances. Updates demographic and insurance information and verifies referrals and prior authorizations when needed.
  3. Schedules patient appointments, coordinates cancellations, and reschedules. Provides accurate, detailed information regarding test preparations, time patient to arrive, and any other directional information needed by patient.
  4. Coordinates the scheduling of appointments that are more complex, test and procedures. Instructs the patient on procedural protocols (ie: medication guidelines, good/beverage guidelines, check-in time and directions to the facility).
  5. Updates insurance, financial responsibility and other data when changes or additions occur, and communicates to patient as appropriate. Ensures insurance and patient information obtained is complete and accurate, applying acquired knowledge of government and third party requirements.
  6. Identifies, reports and resolves problems regarding registration or authorizations to appropriate individuals and departments.
  7. Monitors patient flow to ensure they are cared for in the most efficient and courteous manner. Assists patients: arranging transportation needs, providing directions, locating wheelchairs, etc.
  8. Performs visit closure including checking out patients, scheduling follow-up appointments and providing patients with any necessary documents.
  9. May educate patients, staff and providers regarding prior authorization requirements, payer coverage, eligibility, documentation and insurance changes.
  10. Acts as a resource to patient access and scheduling services and assists department leadership with orientation and training for new staff members.
  11. Maintains confidentially of patient information, in accordance with Tomah Health's policy and procedures.
  12. Activates emergency codes and follows established disaster protocols.
  13. Contributes to the prevention of infectious disease among employees and patients by adhering to infection control policies and procedures.
  14. Contributes to departmental and hospital operations by performing other related duties that may be assigned and/or requested.
STANDARDS OF BEHAVIOR
  1. WORK ETHICS STANDARD: Affirm a commitment to making the Tomah Health work environment better through: patient advocacy, continuing education, and valuation of each individual person.
  2. COMMUNICATION STANDARD: Affirm a commitment to use open and honest communication with all Tomah Health customers (in-house & community-wide) through: basic customer courtesy (phone, written, face to face) and active listening.
  3. TEAMWORK STANDARD: Affirm a commitment to be a proud, dependable Tomah Health TEAM member through: basic customer courtesy, patient advocacy, flexibility, and valuation of each individual person.
  4. QUALITY STANDARD: Affirm a commitment to provide respectful, compassionate, quality care with integrity to all Tomah Health customers (in-house & community-wide) through: job excellence, patient advocacy, and self-dignity.
  5. PROFESSIONALISM STANDARD: Affirm a commitment to professional conduct towards all Tomah Health customers (in-house & community-wide) through: collaboration, teamwork, appearance, environment, and valuation of each individual person.
  6. ATTITUDE STANDARD: Affirm a commitment to maintain a positive, professional perspective towards all Tomah Health customers (in-house & community-wide) through: honest feedback, confidentiality, basic customer courtesy, and valuation of each individual person.
EDUCATIONAL REQUIREMENTS
  1. High School diploma or equivalent required.
  2. Minimum of two years of experience in healthcare financial or healthcare services desired.
  3. Advanced training in medical terminology, insurance plans or healthcare operations is highly preferred.
QUALIFICATIONS/SKILLS
  1. Must be consistently pleasant and helpful and possess strong customer service skills to interact positively with external and internal customers.
  2. Must present a professional attitude and appearance at all times.
  3. Excellent verbal and written communication skills including proper grammar and punctuation. Ability to effectively communicate with a variety of patients, staff and providers.
  4. Must be able flexible and be able to work 8 and 12 hr. days and assist with weekend coverage as needed.
  5. Detail oriented, able to multitask and identify tasks that need to be done without being told.
  6. Demonstrates understanding of insurance benefits and able to communicate those benefits to our patients. Uses department reference documents to facilitate communication with patients regarding insurance authorization requirements.
  7. Ability to work in a fast-paced environment with frequent interruptions.
  8. Advanced computer and office equipment knowledge and ability to operate Windows based programs.
  9. Ability to operate a multi-line phone system.
  10. Demonstrate a willingness to learn new tasks, and to embrace change with an open mind.
  11. Demonstrates the verbal and communication skills needed to communicate in a clear and effective manner-especially during stressful situations.
JOB REQUIREMENTS
  1. The PAR II must become certified by the National Association of Healthcare Access Management (NAHAM) as a Certified Healthcare Access Associate (CHAA) in within 1 year of their date of hire.
  2. The PAR II must currently be or become a department preceptor for patient access and scheduling within 1 year of their date of hire.
  3. Required to move frequently from the desk to other areas of the office environment.
  4. Ability to assist patients who are in need of medical attention by transporting or summoning for immediate assistance (wheelchair, etc.).
  5. Periods of extended sitting may be required.
  6. Visual acuity is essential for working with written materials and in reviewing related computer screens.
  7. Auditory skill is required for phone and patient contact situations.
  8. Clear speech is essential for phone and patient contact situations.
  9. Must possess the ability to obtain file folders from shelving located from floor level to shoulder level, place files in storage boxes and be able to lift storage boxes (weighing approximately 40 pounds) and stack them to a level of shoulder height.
  10. May also need to obtain records stored remotely. This requires the ability to climb stairs, obtain storage boxes weighing 20 pounds, twisting, bending and reaching at a level of shoulder height to obtain the appropriate storage box.
  11. Requires the physical ability and stamina to climb stairs, lift, bend, reach, stoop, kneel, crouch or walk