Patient Access Service Re

Front-line Revenue Cycle Team Member

Front-line Revenue Cycle Team member of the WHMC. Under normal supervision is generally responsible for the efficient and orderly processing of scheduled cases, reservations and or registrations of Emergency Department/ Ambulatory Surgery / Pre-Testing / Clinic / Referred Ambulatory / Recurring Visit and/or Inpatient patients. Performs clerical duties necessary to encourage patient throughput and access to medical care while providing and securing financial information necessary for revenue generation. This may include but is not limited to obtaining and recording patient demographics, contacts insurance information, notifications and precertification.

Professional Requirements

Must type minimum of 40 word per minute. Use of computers for data entry a plus.

Multitasking necessary, reasonable distractions so as to cause stress.

Ability to prioritize and reprioritize as additional tasks develop or are assigned.

Able to work well with a team and independently.

Previous front-line medical office, billing, or hospital registration experience or skills are must.

Knowledge Insurance verification process for HMO, MCR, MCD, BC, WC, NF, liability and traditional indemnity third party billing and payers is a must.

Mature, accountable and punctual: reports to work promptly as schedule.

Incorporates professionalism, sensitivity to cultural and linguistic diversity, and makes use of customer service and satisfaction skills in every transaction conducted. Takes initiative and is proactive when servicing customers.

Collaborates with and is courteous and respectful to all WHMC staff, patients, physicians, nurses, other clinical staff and WHMC associates

Flexible and able to process and complete either Elective, Amb Surg, Urgent Emergency patient admissions/registrations and performs all related duties as established in departmental policy and procedures.

Electronically checks any and all electronic and web verification resources to enable the PASR to identify if any accounts registered as Self-Pay have insurance. Complies with WHMC Sliding Fee and Financial Aid Policies

Ensures that patients are made aware of hospital policies and procedures, including those regarding financial obligations, co-payments and deposits, personal items and visitation rights.

Offers patients that remain "true" Self-Pay a Medicaid Document List and refers those patients to the on-site Medicaid Office if Inpatient and Off-site Medicaid if Outpatient. Documents patient accounts accordingly to communicate efforts of the PASR Team

Interviews patients/patients' representatives in person, at bedside, or by phone to obtain necessary demographic and financial/insurance information for each admission/registration; maintains patient confidentiality at all times.

Obtains Verification, provides necessary insurance notification, obtains precertification and authorizations for Commercial,MCD, MCR, BC, HMO, Champus, MCDPCPs, MCRHMOs, No Fault, and Worker's Compensation.

Verifies benefit eligibility & Auth requirements, via tel, fax, Web & Electronic Verification tools. Inputs Subscriber, Pol.#s, Group Name & Plan Types in accordance with policy. Contacts employers to obtain WC or NF Info on WC and NF cases.

Courteously answers telephone calls and responds to inquiries and/or requests in accordance with established policy and procedures. Routes calls or takes messages as appropriate.

Accepts reservations for Direct Inpatient Admissions and Ambulatory Surgery procedures as requested by the Attending Physicians or their respective designees and ensures the completion of reservation forms.

Translates verbal or written diagnosis and procedures into appropriate ICD-9 or CPT code in order to obtain authorization.

Appropriately, Schedules, Pre-Admits, or Admits patients as per established policy. Enters necessary comments and collection notes.

Records advanced directive status of patients and collects, charts and files Advanced Directives. Advanced Directive Librarian. Collaborates with appropriate Hospital Associates regarding Special

Advanced Directive Circumstances".

Collects patient Discharge Notice Slips. Promptly enters discharges in computer system and ensures that vacant beds are accurately reflected in the computer system and patient bed board at all times.

Assigns beds in accordance with established bed priority, uses bed tracking and census tools to expedite processing of decisions to admit.

Coordinates and documents intra-hospital patient room transfers in collaboration with the Nursing Staff and in accordance with priorities established in departmental policy and procedure

Assigns patients to a hospital room and bed, based on sex, diagnosis, age, current patient census and in accordance with guidelines and priorities established in departmental policy and procedures.

Obtains patient signatures authorizing treatment, assignment of benefits release of information and acknowledging receipt of patient packages. Prepares initial Medical Record Chart for encounter, identificaiton bands and labels.

Where appropriate, assists families, Funeral Homes and Coroner's Office regarding inquiries and documentation in the preparation of death Certificates.

Where appropriate, Birth Registry PASRs Only: Accurately & Timely processes Birth Worksheets, Birth Certificates and obtains signatures from MDs. Processes requests for Newborn MCD and Social Security numbers. DOH Liaison.

Where Appropriate, Birth Reg Only: Accurately and Timely Processes Spontaneous Termination of Pregnancy, may request Medical Records.

Where Appropriate, Birth Reg Only: Conducts daily L&D and Maternity Unit walk throughs to interview patients. Supports team in effort to secure financial information as needed,

Where Appropriate, Financial Follow-up PASRs: Review and accurately update or revise facesheets and patient information to ensure notifications, verifications and authorizations are secured. Use all possible tools to verify benefits.

Where appropriate, Financial Follow-up PASRs: Timely Report changes to Patient information to Utilization Management, Medicaid Office and other Hospital Associates as necessary.

Where appropriate, PST PASRs: Promptly Prepare Testing Requistions affixing Labels as necessary. Attach all necessary forms to Pre-Admission package i.e. Adv. Directives, Multiparity, Hysterectomy, NF, WC. Place calls to BMP Director as necessary

Performs all other duties as required.

Position Requirements

This position requires a minimum formal education of High School Diploma or equivalent and a minimum of 1 year job-related experience. Desired (not required) criteria include: Knowledge of Medical Terminology. Good office skills. Professional appearance and pleasant personality. Congenial manner - ability to deal with/assist persons under stress. Good telephone personality/manner.

Comments

May see blood, other body fluids. May see patients who are intubated, using prosthetic devices or limbs, or otherwise in uncomfortable situations. Positions. May have to deal with family of patients.

Shift: M-F 3pm-11pm alternate weekends

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Wyckoff Heights Medical Center