Description
JOB PURPOSE OR MISSION: Provides excellent customer service during the patient access/intake process, executing patient access through the continuum of the revenue cycle that supports efficiency, cost reduction and service improvement. Performs duties according to established hospital procedures for the age population served, as defined in the department's scope of service.
PERFORMANCE CRITERIA
CRITERIA A: Everyday Excellence Values - Employee demonstrates Everyday Excellence values in the day-to-day performance of their job.
PERFORMANCE STANDARDS:
• Demonstrates courtesy and caring to each other, patients and their families, physicians, and the community.
• Takes initiative in living our Everyday Excellence values and vital signs.
• Takes initiative in identifying customer needs before the customer asks.
• Participates in teamwork willingly and with enthusiasm.
• Demonstrates respect for the dignity and privacy needs of customers through personal action and attention to the environment of care.
• Keeps customers informed, answers customer questions and anticipates information needs of customers.
CRITERIA B: Corporate Compliance - Employee demonstrates commitment to the Code of Conduct, Conflict of Interest Guidelines and the GHS Corporate Compliance Guidelines.
PERFORMANCE STANDARDS
• Practices diligence in fulfilling the regulatory and legal requirements of the position and department.
• Maintains accurate and reliable patient/organizational records.
• Maintains professional relationships with appropriate officials; communicates honesty and completely; behaves in a fair and nondiscriminatory manner in all professional contacts.
CRITERIA C: Personal Achievement - Employee demonstrates initiative in achieving work goals and meeting personal objectives.
PERFORMANCE STANDARDS
• Uses accepted procedures and practices to complete assignments. Uses creative and proactive solutions to achieve objectives even when workload and demands are high.
• Adheres to high moral principles of honesty, loyalty, sincerity, and fairness.
• Upholds the ethical standards of the organization.
CRITERIA D: Performance Improvement - Employee actively participates in Performance Improvement activities and incorporates quality improvement standards in his/her job performance.
PERFORMANCE STANDARDS
• Optimizes talents, skills, and abilities in achieving excellence in meeting and exceeding customer expectations.
• Initiates or redesigns to continuously improve work processes.
• Contributes ideas and suggestions to improve approaches to work processes.
• Willingly participates in organization and/or department quality initiatives.
CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.
PERFORMANCE STANDARDS
• Effectively manages time and resources
• Makes conscious effort to effectively utilize the resources of the organization — material, human, and financial.
• Consistently looks for and uses resource saving processes
CRITERIA F: Patient & Employee Safety - Employee actively participates in and demonstrates effective patient and employee safety practices.
PERFORMANCE STANDARDS
• Employee effectively communicates, demonstrates, coordinates and emphasizes patient and employee safety.
• Employee proactively reports errors, potential errors, injuries or potential injuries.
• Employee demonstrates departmental specific patient and employee safety standards at all times.
• Employee demonstrates the use of proper safety techniques, equipment and devices and follows safety policies, procedures and plans.
JOB FUNCTIONS
ESSENTIAL JOB FUNCTIONS include, but are not limited to:
1. Facilitates patient safety with accurate and timely patient identification.
PERFORMANCE STANDARDS:
• Follows all policies and procedures to accurately identify the patient.
• Prior to applying the patient's armband, reviews all patient identifying data on the armband with the patient. Does NOT apply armbands that are not correct. Replaces armbands when a discrepancy had been identified and corrected.
• Documents on appropriate form any variation from normal process.
2. Timely, accurately and consistently completes the patient access process which may include pre-registration, registration or collections based on the patient's identified needs at the time service is rendered.
PERFORMANCE STANDARDS:
• Conducts a confidential and professional interview with patients or the patient's representative and completes pre-registration, registration or discharge collections accurately.
• Patient access functions are completed timely, promoting patient safety and minimizing patient delays.
• Initiates quick registration processes in the ER or, in other areas, upon request of the clinical staff, when the patient's care is deemed emergent or urgent.
• Promptly performs initial quick registrations on targeted patients and completes the access process as soon as possible.
• Follows all Emergency Medical Treatment and Labor Act (EMTALA) regulations.
• Registers patients to the correct location and bed according to information obtained from the Physician's order, which may be obtained from bed board, case manager, nursing supervisor, patient's nurse or ED charge nurse.
• Maintains compliance in completing all documents required by specific payers for each patient registration.
• Communicates with Insurance Representatives when necessary to effectively promote continuity in pre-certification/insurance verification process.
• Interrupts insurance verification data as needed and takes appropriate action related to insurance responses.
• Maintains an overall error rate at or below 5%.
• Documents on appropriate form any variation from normal process.
• Performs duties for two areas of responsibility within the Business Services Department.
3. Computes, requests, collects and receipts monies.
PERFORMANCE STANDARDS:
• Requests and collects co-payments, deposits and payments due and documents according to financial policies.
• Accurately accepts and receipts all payments received for accounts as evidenced by correct receipt records.
• Accurately maintains and secures the cash drawer and monies collected at all times, as outlined in the financial policy.
• Delivers deposits to cashier with established timeframes.
• Researches related accounts' outstanding debts and discusses with patient as needed.
• Documents on appropriate form any variation from normal process.
4. Performs activation of account according to standard procedures and disseminates chart appropriately.
PERFORMANCE STANDARDS:
• Completes activation function of all registered or discharged patients facilitating timely patient account functions.
• Disseminates all records and distributes them to appropriate departments according to standard procedures.
• Documents on appropriate form any variation from normal process.
5. Performs all other duties as assigned.
EXPERIENCE REQUIREMENTS
Customer Services Experience Required. Must posses intermediate computer skills with experience in Windows, Excel, Word and Outlook. Prior experience in Insurance or Patient Registration in healthcare environment required. One year of higher education or certification in coding may be substituted for experience, as approved by department management.
EDUCATIONAL REQUIREMENTS
High School Diploma or GED required, higher education preferred.
SPECIAL SKILL, LICENSE AND KNOWLEDGE REQUIREMENTS
Must be able to enter data using a computer with multiple applications. Excellent telephone and communication skills. Must possess basic knowledge of medical terminology.
HIPAA REQUIREMENTS:
Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position including but not limited to: medical record without limitation, patient demographics, lab results, patient financial and 3rd party billing information, patient related complaints, information related to patient location.
SAFETY REQUIREMENTS:
Maintains knowledge of and adherence to all applicable safety practices appropriate to Job Position including but not limited to: incident reporting, exposure control plan, hand washing for all age groups.
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