Job Details
Full-time
615 N. Michigan Street
Clerical
Day
Reports to the Manager or Director. Is responsible for the coordination of services for patients at the assigned clinic or site, which includes: admitting and discharging patients, contacting third-party payers for authorization/documentation/pre-certification, copying patient records and billing and scheduling new patients. Duties may also include performing a variety of routine secretarial duties, (i.e., preparing a variety of statistical or special reports, greeting customers, answering the telephone, filing, etc.).
MISSION, VALUES and SERVICE GOALS
* MISSION: We deliver outstanding care, inspire health, and connect with heart.
* VALUES: Trust. Respect. Integrity. Compassion.
* SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.
Coordinates a variety of rehabilitation patient services at the assigned clinic or site by:
* Admitting and discharging patients, which includes discharging from computer system, completing chart audit form, discharging the patient chart and making the bar code label.
* Communicating, verbally and in writing, with third-party payers in order to ensure appropriate verification of services and payment.
* Scheduling new patients.
* Copying patient records and billing when appropriate for insurance companies, attorneys, subpoenas, patients, Vocational Rehabilitation and Disability Determination Board.
* Preparing, as needed, a variety of statistical reports and associated documentation required by grant guidelines and third-party regulatory bodies, per the Director or Manager.
* Performing a variety of routine secretarial duties (i.e., typing, computer, greeting customers, answering the telephone, filing, etc.).
* Supporting the Director and Manager in the completion of special reports and/or department documentation and utilizing the Hospital computer system to run routine client service and demographic reports.
Registers patients (in order to obtain demographic, physician and insurance information in accordance with established departmental policies and procedures) and collects applicable co-payments and deductibles by:
* Interviewing patients via telephone for pre-admission or upon presentation for admission in the registration area.
* Obtaining identification, demographic, physician and insurance information from patients and accurately entering this information into the Hospital financial system.
* Updating the system after validation of the new patient's financial information.
* Explaining about the possible need to pre-certify with the patient's insurance carrier in order to ensure maximum coverage to the limits of the insured's insurance policy.
* Verifying and documenting insurance coverage via online eligibility systems, internet resources or via telephone.
* Requesting copies of the insurance card(s) and drivers license or other government picture ID to confirm insurance benefits and identification.
* Validating medical necessity via the MCA Compliance Checker where applicable.
* Completing the MSP (Medicare Secondary Payor) questionnaire by asking the patient the questions based on pt availability.
* Requesting payment either during the pre-registration process, when the patient presents for service or at Patient Check Out in ECC in accordance with MHSB's policies and procedures.
* Referring the patient to the Financial Counselors or Eligibility Specialists if they are unable to secure satisfactory payment arrangements and have a self-pay balance of $500 or more. Also assisting in obtaining additional patient information, copies of insurance card(s) and church information.
* Obtaining all required signatures for the "consent to treat" and assignment of insurance benefits forms.
* Obtaining pre-certification information from the insurance company's pre-certification unit (i.e., whether pre-certification is required, if the ordering physician has completed it, etc.).
* When the ordering physician has not completed the pre-certification, calling the physician's office to initiate the pre-certification process and following up until it has been completed.
* When the ordering physician has completed the pre-certification, documenting the authorization and releasing the account.
Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department by:
* Assisting the department to meet or exceed its quality assurance goals.
* Striving to accurately process an optimal number of registrations (or pre-registrations) during one's shift.
* Maintaining records, reports and files as required by departmental policies and procedures.
* Performing time of service collections effectively by achieving assigned collections goals and maintaining strong patient relations.
ORGANIZATIONAL RESPONSIBILITIES
Associate complies with the following organizational requirements:
* Attends and participates in department meetings and is accountable for all information shared.
* Completes mandatory education, annual competencies and department specific education within established timeframes.
* Completes annual employee health requirements within established timeframes.
* Maintains license/certification, registration in good standing throughout fiscal year.
* Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
* Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
* Adheres to regulatory agency requirements, survey process and compliance.
* Complies with established organization and department policies.
* Available to work overtime in addition to working additional or other shifts and schedules when required.
Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:
* Leverage innovation everywhere.
* Cultivate human talent.
* Embrace performance improvement.
* Build greatness through accountability.
* Use information to improve and advance.
* Communicate clearly and continuously.
Education and Experience
* The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a high school diploma (or equivalent); additional college-level business courses are preferred. Two to three years of progressively responsible experience in a related healthcare services environment is required.
Knowledge & Skills
* Requires a thorough knowledge of general office policies and procedures, secretarial functions and rehabilitation patient services.
* Demonstrates the ability to operate and effectively utilize a multiple line telephone system and the Hospital information system.
* Demonstrates well-developed communication skills, both verbal and written, needed to effectively interact with clients, staff and third-party payers (both internal and external).
* Demonstrates knowledge of and a commitment to Beacon Health System's mission and values; and the organization's goal of providing exceptional patient experiences by following the Performance Essentials.
* Requires basic office and keyboarding skills (with the ability to type a minimum of 40 wpm) and the ability to use designated reference materials and office equipment (i.e., computer, printer, fax machine, calculator, etc.).
* Requires effective telephone skills (for example, to accurately take and relay information about patients, physician orders and referrals).
* Demonstrates proficient computer skills (i.e., data entry, word processing and spreadsheets). Requires the ability to use multiple databases (such as Pathways Healthcare Scheduling, RelayHealth, Cerner and PCA Compliance Checker).
* Requires a complete understanding of time of service collections. Specifically, must understand why it is necessary and must be able to effectively communicate this to MHSB's patient community as necessary.
* Requires basic knowledge of medical terminology, private insurance coverage (and managed care).
* Demonstrates the interpersonal skills necessary to interact effectively with patients from various backgrounds in a professional, enthusiastic, courteous, friendly, caring and sincere manner. Also demonstrates the ability to maintain effective working relationships with other departments, physicians and their office staff.
* Demonstrates the verbal communication skills needed to communicate in a clear and effective manner when conducting patient interviews, answering patients' questions and communicating with other departments and physician offices.
* Good listening skills are required. Sensitivity to individuals who do not speak English as their first language is expected.
Working Conditions
* Must be able to be effective in a busy, dynamic and fast-paced office environment.
Physical Demands
* Requires the physical ability and stamina to perform the essential functions of the position.