Job Details

PATIENT ACCESS REP

  2020-12-01     University of Maryland Medical System     Cheverly,MD  
Description:

What You Will Do:

POSITION SUMMARY
Under regular supervision performs all outpatient and inpatient registration functions including hospital point of service collections, electronic patient bed management responsibilities and insurance verification. Process patients through the registration functions as quickly as possible while collecting complete and accurate personal, clinical and financial information. Provides general information to hospital users, patients and families. Communicates effectively to service delivery areas to maximize patient flow and customer service.
The following job description covers the most significant duties performed, but does not exclude other work assignments not mentioned PRIMARY RESPONSIBILITIES
Principal Duties:
Performs accurate and complete Registration/Preregistrations and & Admissions to provide information which will maximize reimbursement, achieve collection rations and meet Account Receivable goals and provide timely and thorough information to all other providers & customers that utilize the patient data.
Interview patients face-to-face or by phone to obtain registration information (prior to service/point of service).
Obtain interpretive services to provide communications for hearing impaired or when there is a language barrier preventing completion of the registration process.
Ensures that financial protocols and requirements are met while providing caring access to service at UM CAP.
Contact insurance companies for patient benefits and authorization approval for patient care.
Completes departmental intake forms and shift/day end reports fully and accurately.
Minimizes 3rd party payer denials by verifying authorization of service prior to forwarding patients to service delivery areas.
Obtains patient signatures on Consent forms, HIPAA, Observation Notice, Insurance Waiver, Important Message from Medicare and other important forms as required within the Hospital's policies.
Performs departmental administrative functions as required. Answers all incoming telephone calls according to departmental telephone standards.
Document on line admission or other patient service dates to initiate payer and hospital utilization review process.
When necessary, pursue actual approval and authorization number from the insurance based upon diagnosis, service and contract coverage.
Maintains current knowledge of insurance requirements and an understanding of the changing demands of federal regulations and organizational requirements, UMCAP/PAS policies and procedures, Joint
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PRIMARY RESPONSIBILITIES
Commission, state and local mandates communicated by email, memorandum, educational matrices and
in-services.
Work with insurance team specialist to maintain patient flow while resolving financial issues.
Communicates effectively with service areas when unresolved financial issues threaten appointment
schedules and request from physicians that service be rescheduled when payment from insurance or
patient is doubtful
Negotiates deposits and payment arrangements with patients and or guarantors and attempt to collect
patient deposits or other uninsured balances on accounts
Conducts Bed Assignment duties accurately and timely.
Contacts physician offices for orders for patient care.
Communicates with Nursing, and Environmental Services regarding bed placements and discharges for
inpatients.
Ensures that all required documents are scanned into the correct individual patient record.
Performance of any requested assignments, tasks or duties within the Patient Access department and as
required within the scope of the job description.
Rotate to various patient access department registration portals as needed.
Customer Service:
1. Greets customers in courteous, friendly, respectful and professional manner at all times, including
maintaining eye contact when appropriate.
2. Follows communication protocols to both internal and external customers, including introducing him/herself
with job title and experience, asking open ended questions, such as "How may I be of help to you?" using
the customer's name as soon as it is learned.
3. Responds promptly and appropriately to customer questions/concerns/complaints and attempts immediate
resolution.
4. Keeps customer's information confidential, including public places such as elevators or the cafeteria.
5. Provides assistance and offers help immediately, including finding someone else to meet the request, if
unable to do so him/herself. Introduce other staff to customers when a hand-off occurs and explain that the
person will provide excellent service.
6. Demonstrates commitment to excellent service recovery when a customer's expectations have not been met.
Commitment to Co-Workers:
1. Offers assistance to colleagues and other departments when needed.
2. Takes responsibility for solving problems regardless of origin; completes assignments, and respects
deadlines.
3. Resolves conflict directly with colleagues and seeks assistance from others if the issue cannot be resolved.
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PRIMARY RESPONSIBILITIES
Refrains from criticism in public.
4. Mindful and respectful of others' time and schedules. Attends meetings on time and communicates any absences.
5. Provides co-workers with a status report for continuity of workflow when planning to be out of the office, off the unit, or away from the department
Communication Etiquette:
1. Respectful, courteous and professional in all forms of communication and follows facility's service communication protocol in all interactions.
2. Refrains from use of personal cell phone in patient care areas.
3. Does not text or use e-mail during meetings (except for exigent or emergency situations).
4. Maintains an appropriate voicemail message and when away from the office has an out-of-office email message that is brief, current, and includes name and department and offers the caller options if possible.
5. Returns email and voicemail messages promptly but no later than within one business day (24 hours).
Self Management:
1. Reports to work appropriately groomed and in compliance with the Hospital's dress code. Wears identification badge at all times at chest level and facing outwards so identification is clearly visible.
2. Complete all assignments within deadlines or negotiates alternative actions and time frames in order to achieve desired outcomes.
3. Completes mandatory, annual education and competency requirements.
4. Follows UMCAP safety, infection control and employee health standards.
5. Demonstrates responsibility for personal growth, development and professional knowledge and competency.
6. Adhere to all UMCAP and department policies and procedures, including Code of Conduct and professional behavior standards. Does not exceed Hospital guidelines in reference to attendance, punctuality, and use of sick and unplanned absences. Provides notification of absences, lateness and vacation requests according to department guidelines. Respects length of time for lunch and break times.
7. Reviews, signs, and adheres to UMCAP and/or departmental confidentiality statement.
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For Supervisory Positions Only:
This position supervises jobs that are (check all that apply):
Service Admin. Support Technical Professional
Supervisory Management Sr. Management
Supervisory responsibilities typically include (check all that apply):
Evaluating Job Performance Disciplining/terminating Scheduling - Work/Time Off
Recommending Salary Actions Interviewing/Hiring Coaching/Mentoring
Directing/Assigning/Reviewing Work Training/Developing Promoting
Approximate Number of Employees Supervised:
Exempt (Salaried): Non-Exempt (hourly):
POSITION REQUIREMENTS:
Licensure/Certification/Registration
Required: Not Applicable.
Preferred:
Other:
Life Support Certification: (Check all that apply)
Basic Life Support - Health Care Provider (BLS-HCP) Advanced Cardiac Life Support (ACLS)
Pediatric Advanced Life Support (PALS) Neonatal Resuscitation Program (NRP)
Education/Knowledge (see attached explanation sheet)
Attained Level: High School or Equivalent
Preferred: Some college level course work
Completed Course Work/Program: Business, healthcare administration, social work, or related.
Applicable Experience
Experience (years): Required: One year Preferred: Two or more
Experience(describe required & preferred): One year of experience providing direct customer service. A hospital setting is preferred

What You Need to Be Successful:

POSITION REQUIREMENTS:
Licensure/Certification/Registration
Required: Not Applicable.
Preferred:
Other:
Life Support Certification: (Check all that apply)
Basic Life Support - Health Care Provider (BLS-HCP) Advanced Cardiac Life Support (ACLS)
Pediatric Advanced Life Support (PALS) Neonatal Resuscitation Program (NRP)
Education/Knowledge (see attached explanation sheet)
Attained Level: High School or Equivalent
Preferred: Some college level course work
Completed Course Work/Program: Business, healthcare administration, social work, or related.
Applicable Experience
Experience (years): Required: One year Preferred: Two or more
Experience (describe required & preferred): One year of experience providing direct customer service. A hospital setting is preferred.
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Must be able to type 25 WPM and pass clerical exam.
Ability to speak read and write in English fluently, a secondary language is a plus.
Must have strong verbal and written communication skills.
Medical Terminology preferred.
Ability to adapt to technical upgrades and changes throughout the hospital system.
Ability to work independently, and take initiative in executing work task
Ability to work cooperatively with all types of personalities inside and outside the organization
Readily accepts responsibilities for one's own actions and behaviors
Serves as an effective resource and acts as a member of the team in a supportive manner. Shows willingness to offer or request assistance when needed.
Good interpersonal skills with ability to work and communicate (verbally and written) with all levelsof hospital personnel, including physicians, clinicians, and all customers
The position requires continuous training to upgrade skill set to support transformation a sustainability.

We are an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.


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