Patient Access Rep PT Shift 3- ED

Job Description

Job Description

Job Title: Patient Access Emergency Dept. Shift Lead Department: Registration

Reports to: Patient Access Manager Revision Date: 10/10/2024

Grade Level: 16 Status: Non-Exempt

Job Summary:

The Patient Access Representative Shift Lead is responsible for staffing and operational activities within patient access, including enforcing departmental policies, practices and procedures, employee training and orientation, reporting departmental concerns, and providing recommendations for improvement. Communicates as a productive team member with physician offices, staff, multiple service areas, and patients to obtain demographic and insurance information for preregistration and registration on all patients for prompt and accurate patient billing. Performs quality control to ensure all patient ED registration to also include admission, OP ancillary registration & scheduled study or walk-in visits are compliant and accurate. Ensures worklists are reviewed and completed timely to include courier registrations. Communicates Oswego Health’s financial policies and required documents to patients and identifies patients that require financial counseling.

Duties/Responsibilities:

• Work with physicians, physician’s office staff, patient’s patient families, ED/SB staff and other members of the health care team to obtain accurate information for registration on all patients and ensure that registration flow is consistent with timelines.
• Perform inpatient, outpatient, scheduled, and pre-registered patient registrations; Interview patient and/or guarantor to obtain and process accurate and complete patient information, including appropriate signatures on required forms; Discharge inpatients/outpatients.
• Answer telephones to administrative calls, third party visitors, and resolve complaints; maintain the operator logs.
• Scan all required patient information, all insurance and state ID cards, Advanced Directives, and other registration forms. Receive notices of service requisition from providers. Record pertinent data for claim submission.
• Obtain accurate demographic and insurance information, collect on self- pay accounts, co-payments and deductibles.
• Provide patients with all required notices, not limited to the Health Care Proxy, HIPAA, and the Patient Bill of Rights; Export images to CD’s, film/image sign out and release.
• Complete and process a variety of forms, including but not limited to the Medicare questionnaire and service authorizations.
• Utilize the Meditech system as well as the electronic ordering system; ensure all electronic ordering registration procedures include courier procedures.
• Receive cash, credit card or other form of payments, apply transactions utilizing credit card machine and perform discounts as appropriate. Opening and closing cashiering windows and balancing payments; adhere to Accounting of Disclosures for patient record requests.
• Perform third party payer verification and payer eligibility requirements with knowledge of No Fault and Workers Compensation claims.
• Initiate required service authorizations. Document pertinent data for B/AR and Case Management.
• Complete daily, weekly, monthly tasks in a timely manner, inclusive of but not limited to financial support activities and designated department and organization competencies.
• Review orders/ requisitions and diagnosis to ensure compliancy and legality of the order. Perform all quality measures instructed to maintain positive patient flow and services. To include correct diagnosis code, correct scheduled study, authorization requirements, provider entry, and other forms of quality procedures to ensure positive customer satisfaction and procedure compliancy.
• Complete all department documentation accurately as assigned based on familiarity with basic forms of medical terminology, seek assistance or resources to ensure accurate documentation of patient visit complaints and admission diagnosis descriptions.
• Follow all physician entry designated procedures to include but not limited to Primary Care, Doctor Other, multiple locations and address changes.
• Communicate the hospitals’ financial policies and other required documents to all patients; Identify patients who require financial counseling.
• Open/Close the cash drawer, balance drawer and submit daily deposit.
• Maintain positive, collaborative relations with patients and their families, physicians and office staff, co-workers, and other members of the healthcare team to provide quality care, create a positive experience and support Oswego Health’s values.
• Ensure compliance with regulating agencies and Third Party payers with respect to admission and discharge practices.
• Assist in the training and orientation of new employees hired for ED registration. Educate staff on any policy and/or procedure relating to ED and Admission functions or responsibilities.
• Communicate any departmental issues or concerns with appropriate manager or team leader.
• Perform other duties as assigned.

Required Skills/Abilities (Unit Specific):

• Clerical skills and proficiency in basic computer software, including Microsoft Office Suite.
• Skilled in PC/CRT data entry.
• Knowledge of medical terminology, 3rd party Insurance, registration and revenue cycle preferred.
• Professionalism, interpersonal skills with ability to establish consultative relationships.
• Excellent written and verbal communication skills, time-management skills, and ability to work under conditions of intermittent interruptions.
• Ability to type 30/40 words per minute.

Education and Experience:

• High school diploma or GED required.
• Associates degree in Business Administration preferred.
• Data Entry and computer knowledge required
• Experience in customer service with strong communication skill required.
• 1 year experience in a customer service and/or medical office setting with knowledge of Medicare, Medicaid and other contract payers preferred.
• Familiarity or experience with Advance Beneficiary Notice, precertification, ICD10 coding, and/or CPT codes preferred.

Working Conditions:

• Requires remaining current with all Patient Access implementations and education, and emails.
• Must be able to work alternate weekends and holidays with rotating shifts.
• Position requires working as needed at any of the Patient Access sites including: Switchboard, and other potential hospital cross training needs in other Access Departments and facilities.
• Requires extended periods of sitting and using computers, working with work station on wheels and standard office equipment including, but not limited to phones, fax machines, printers, and scanners.
• Requires periods of standing and registering patients in the patient care area.
• Requires use of computer software including, but not limited to, Meditech, Clockwise, Insurance web sites, electronic eligibility and electronic ordering system.
• Attendance ensures that job requirements are met.
• Ability to perform light lifting (up to 15 pounds) using proper body mechanics.
• Occasionally requires assembling, using, checking and maintaining equipment.
• Actively participates in cross-training, Quality Assessment programs, CQI, in-service programs, and mandatory classes; completes department specific requirements/competencies. Accepts assignments to other departments as assigned.

• Complies with DOH requirements for annual health assessments and required immunizations.

Pay Range; $17.34-$20.81/hr

Employee salary is based on commensurate experience and other qualifications.

The mission of Oswego Health is to provide accessible, quality care and improve the health of residents throughout Oswego County. As a nonprofit healthcare system that was established in 1881, Oswego Health is proud to continue to be one of Oswego County’s largest employers. More than 1,200 employees spread throughout its 17 locations, work for the Oswego Health system, which includes the 164-bed community hospital with a brand new Medical Surgical Unit, a 32-bed state-of-the-art psychiatric acute-care facility with multiple outpatient behavioral health service locations, The Manor at Seneca Hill, a 120-bed skilled nursing facility, and Springside at Seneca Hill, an independent retirement community. The health system also operates Oswego Health Home Care, the only hospital-based certified home healthcare agency in the County as well as two outpatient centers, including the Fulton Medical Center, offering urgent care, lab, medical imaging, physical therapy, and occupational health services; and the Central Square Medical Center, offering urgent care, lab, medical imaging, and physical therapy services. In addition, Oswego Health includes the Oswego Health captive professional corporation, Physician Care P.C., providing physician services in orthopedics, cardiology, ENT, gastroenterology, breast care, audiology, general surgery, bariatrics, and primary care.

EQUAL EMPLOYMENT OPPORTUNITY

Oswego Health is committed to providing equal opportunity in all employment-related matters, without regard to race (including traits historically associated with race), creed, color, religion, sex/gender, national origin, age, marital or familial status, disability, pregnancy-related condition, sexual orientation, gender identity, gender expression, transgender status, citizenship status, ancestry, arrest/conviction record, military or veteran status, domestic violence victim status, genetic predisposition or carrier status, reproductive health decision making, relationship or association with a member of a protected category, or any other legally protected characteristic. Decisions affecting your position including, but not limited to, recruitment, hiring, placement, promotion, transfer, compensation, benefits, training, tuition assistance, leaves of absence, disciplinary action, layoff/recall, and terminations will be made in accordance with this policy.