Patient Access Clerk

Description POSITION TITLE: Patient Access Representative DEPARTMENT: Patient Access/Admissions EMPLOYEE REPORTS TO: HIM Director or Designee SUPERVISES: N/A FLSA STATUS: Non-Exempt or Exempt EMPLOYMENT STATUS: Full-time, Part-time, or Per Diem SECTION I – Description of Position This job description is a record of the essential functions of the listed job. The

provides the employee, CEO, Human Resources, applicants, and other agencies with a clear understanding of the job, where it fits into the organization, and the skill and work requirements in relation to other jobs. Jobs are always changing to some degree, and the existence of the approved job description is not intended to limit normal change and growth. The facility will make reasonable accommodation to otherwise qualified individuals who are capable of performing the essential functions of the job with or without reasonable accommodation.

POPULATION SERVED The position does not involve direct patient care for a population of patients ages 18 and older. Age specific experience and/or special training and/or expertise are not required to serve this population.

Under the direction of the HIM Director or Designee, the Patient Access Representative is responsible for facilitating the patient registration flow, including such activities as point of service patient identification; gathering demographic information; securing financial, third-party, and sponsorship data; obtaining required signatures and documents needed for compliance and appropriately collecting co-payment and reconciling cash.

The Patient Access Clerk admits patients by gathering and recording physician, patient, and payment responsibility information; answering questions; providing hospital and hospital services information. Attends telephone inquiries from patients, Case Managers, Physicians, Social Workers and outside agencies. Processes financial clearance prior to admissions by contacting insurance carrier, thereby assuring payment before patients are admitted.

Assists in maintaining the Admissions Department on a daily basis.

Pre-admits patients by receiving bookings from referring facilities and or physicians; confirming admitting privileges of physicians; interviewing patients; entering patient information to pre-admissions database. Provides patients with information by explaining hospital admission policies and forms, time of admission, room selection, TV, visiting hours, telephone availability, cell phone restrictions, answering inquiries.

Secures payments by screening insurance information; identifying patients requiring pre-admission approvals from third-party payers; verifying approvals; notifying patient accounts department of self-paying admissions. May prepare admission folders by gathering admission paperwork for scheduled patients. Greets and receives patients to be admitted by conducting personal interviews; entering demographic and insurance information; confirming pre-admission information; obtaining signatures on legal consents and insurance forms; receiving payment and issuing receipts; distributing patient information literature.

Verifies patient identify by checking identification; preparing and placing identification band on patient.* Ensures patient's arrival to hospital room and or testing area by assigning patient beds; notifying nursing unit of patient's arrival; calling volunteer to transport the patient to the assigned area. Provides information to the public by answering admitting procedure, hospital regulation and service inquiries of patients and the public, referring inquiries.

Serves and protects the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and DNV standards. Accomplishes individual and team goals and objectives established by supervisor based on prior performance evaluation. Consistently demonstrates commitment to customer service excellence in all interactions with patients, family members, visitors and other staff that are consistent with the Customer Service performance standards.

Continually participates in building and maintaining positive working relationships through effective communication, performance improvement and teamwork efforts. Demonstrates the ability to clearly and effectively communicate (to include reading, writing, and speaking) to all patients, family members, visitors and other staff members with the expectation that each employee, within the context of their specific job duties, can read, interpret, understand, and communicate clearly and effectively in order to ensure proper understanding, all written/verbal communication are followed and information is shared appropriately.

Accomplishes admissions and hospital mission by completing related results as needed. Maintain updated bed ability and enters patient admitting information on to Daily Census and routes printed copy to clinical departments via fax and Share Point. Maintain a professional appearance as outlined in the Coalinga Regional Medical Center Appearance Policy and project a business-like decorum at all times with patients, visitors, physicians, clinical staff and team.

Alerts necessary departments of admission and any special requirements via fax, Share Point and electronic health record. May assist in obtaining signatures for consents, etc. Answer phones: emails and perform any other duties pertaining to the Admissions Department.

Requirements POSITION QUALIFICATIONS High school graduate or equivalent, and one (1) year customer service experience preferred in a Healthcare setting. Insurance verification experience and/or registration is preferred. Must possess good oral, written and interpersonal communication skills.

Other desired

• Demonstrates ability to consistently achieve a high level of accuracy and attention to detail Demonstrates perseverance, concentration, resourcefulness and good reasoning ability Demonstrates ability to cope with interruptions, remember pertinent guidelines, policies and procedures Ability to organize and prioritize work Ability to work as a team member Some knowledge of office computer software packages, including spreadsheets and word processing Enhances organization reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments DEMANDS AND CHARACTERISTICS OF WORK, EQUIPMENT USAGE, AND WORK ENVIRONMENT PERCENTAGE OF WORK TIME Standing/Walking -34
• 66% Sitting -34
• 66% Twisting -34
• 66% Lifting/Carrying -34
• 66% Pushing/Pulling -34
• 66% Climbing (Ascending/descending) -1
• 33% Bending/Stooping -34
• 66% Using arm muscles frequently or for extended periods -34
• 66% Using leg muscles frequently or for extended periods -34
• 66% Using back muscles frequently or for extended periods -34
• 66% LIFTING REQUIREMENTS 2
• 10 Pounds -34
• 66% 11
• 20 Pounds -34
• 66% 21
• 30 Pounds -1
• 33% 31
• 40 Pounds -1
• 33% 41
• 50 Pounds -1
• 33% 51 Pounds or More -1
• 33% WORKING ENVIRONMENT Working in hot, cold, wet surroundings -67
• 100% Working outdoors -34
• 66% Working with or near chemicals -1
• 33% Working near radiation sources -1
• 33% Potential exposure to communicable diseases -1
• 33% Working with hazardous waste materials -1
• 33% Utilizing essential upgraded or adaptive equipment as industry standards require -1
• 33% Using hand tools -1
• 33% Potential for cuts and bruises -1
• 33% Driving company or personal vehicle -34
• 66% EXCHANGE OF IDEAS Ability to express or exchange ideas -67
• 100% Ability to understand communication of others with or without adaptive devices -67
• 100% Ability to perform secondary level math -67
• 100% Ability to read at a secondary level -67
• 100% WORKPLACE BEHAVIORS I. RESULTS ORIENTATION – Meets current objectives and positions the organization for future growth. Completes daily tasks and assignments and processes large volumes of work associated with the operation of the department. II. SOCIAL SENSITIVITY - Builds positive relationships based on respect for others. Demonstrates a helpful, positive attitude. Maintains effective communication with peers, medical staff, patients, visitors, and families. III. QUALITY OUTCOMES – Meets and exceeds expectations of internal and external customers. All organizational and departmental standards regarding quality of performance are met. Demonstrates a strong commitment to confidentiality. Participates in quality improvement programs as directed. IV. SAFE WORKING ENVIRONMENT – Demonstrates an awareness of and adherence to safety and legal requirements established at the facility with an emphasis on maintaining a safe environment for all persons working in the facility. Accident/Injury Reporting – Reports any accidents, injuries, and unsafe equipment and conditions to supervisor by the end of the shift and reports any pre-existing conditions as identified by the ADA. Unsafe Conditions – Immediately reports and corrects, if possible, unsafe conditions or equipment. Workplace Standards – Compiles with relevant regulations, standards and policies governing safe workplace environment (OSHA, Accreditation, etc.) Safety Techniques – Maintains current knowledge of all aspects of the facility’s safety program by attending safety-related training as mandated upon hire and thereafter as required by facility. Modified Work – Accepts modified work assignments after receiving the physician’s release to return to work following an accident/ injury. Follows Prescribed/Recommended Treatment – Follows the prescribed/recommended treatment given by treating physician(s) after an accident/injury. V. EDUCATION – Participates in required in-services and educational programs on an ongoing basis. VI. ATTENDANCE AND PUNCTUALITY – Follows all facility guidelines outlining standards of attendance and punctuality. Responsible for reporting to and completing work at assigned times. UNIVERSAL PRECAUTIONS Universal precautions will be observed in order to prevent contact with blood or other potentially infectious materials. Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials. All blood or other potentially infectious materials will be considered infectious regardless of the status. The category shown below is designed to communicate the risk of exposure for this particular position. Category II Tasks involve no contact with moist body substances, non-intact skin or mucous membranes; however, employment may require performing unplanned Category I tasks (i.e. Tasks that involve light contact with moist body substances, non-intact skin or mucous membranes. Department procedures define and require use of minimum protective measures to perform the task). Appropriate protective measures are readily available.