Patient Access Clerk

JOB SUMMARY

The Patient Access Clerk is responsible for the pre-admission, admission and registration of all patients into the hospital in a courteous and professional manner. This position is responsible for interviewing and gathering of complete and accurate data to complete the admission/ registration process accurately, efficiently, and expeditiously. The Patient Access Clerk is responsible for assisting in assigning appropriate units for inpatients, census reporting, and registration of Same Day Surgical patients, outpatients, and emergency patients. Also registers routine outpatient procedures upon request from physician offices and patients. Collects appropriate monies, escorts patients to their appropriate destinations, when applicable. Obtains appropriate signatures, notifies patients/guests of hospital regulations, policies and services. Determines medical necessity on each physician order by assuring all essential elements are present on each order. Strives for superior performance by consistently providing a product or service to leadership and staff that is recognized as ultimately contributing to the patient and family experience. Recognizes and demonstrates understanding of patient and family centered care.

PRIMARY JOB RESPONSIBILITIES

1. Interviews patients courteously to obtain accurate data to admit and register patients.
2. Receives admission information from physicians and their offices, the Emergency Room and patients boarded for surgery.
3. Maintains an updated daily census, available room accommodations, and any patients assigned to those rooms.
4. Maintains logs regarding admissions, discharges, expirations, Emergency room patients etc.
5. Monitors pre-admission requirements and notifies insurance companies who require pre-certification. Assures patients are not admitted without appropriate and necessary referrals, authorizations and/or pre-certifications.
6. Uses a computer system to register all patients. Uses verification system, scanning system and understands all processes.
7. Directs all outpatients to proper ancillary department
8. Receives discharges, transfers and other changes from Patient Care Staff via hospital computer system.
9. Maintains reports in order to keep an updated patient census.
10. Maintains confidentiality of all information.
11. Demonstrates knowledge of, and supports, hospital mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality standards, corporate compliance plan, customer service standards and the code of ethical behavior.
12. Demonstrates knowledge of the Advanced Directive Procedure. Is able to explain verbally general concept of Advanced Directive process. Assures a copy of the Advanced Directive is placed on the patient's chart. If patient does not have an Advanced Directive, assure the patient has the appropriate information and answers any questions the patient may have pertaining to the Advanced Directive.
13. Represents Memorial Healthcare as the welcoming official to all patients and/or visitors in Admitting/Patient Registration, the Emergency Department, and Communications.
14. Maintains a well-organized and clean environment to work at maximum efficiency and prevent transmission of infection and disease.
15. Cross-trains within the department to effectively handle the functions of pre-admission, admission, outpatient registration, emergency registration, scheduling, cashier, verification and communications. (Switchboard)
16. Determines medical necessity on all physician orders. Assures all elements are present. If an element is missing, is responsible for obtaining and notifying physician and/or physician's staff, of element that is required.
17. Determines if Medicare will pay for those procedures that Medicare has determined to be at risk of denial. Assures appropriate diagnosis is present and time element is appropriate to meet Medicare guidelines. Is responsible for notifying the patient of any financial responsibility that may be determined. Obtains appropriate signature to assure patients agreement to pay for said services.
18. Provides estimates for patients in outpatient setting, Emergency Room and or if scheduled for surgery. Advises the patient of their out-of-pocket expenses as needed.
19. Demonstrates knowledge of and supports hospital and departmental mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality statements, corporate compliance plan, customer service standards, and the code of ethical behavior.

DEPARTMENTAL AND ADDITIONAL JOB RESPONSIBILITIES

1. Performs all other related duties as assigned.

JOB SPECIFICATIONS

EDUCATION

1. High School diploma or GED is required.
2. Post high school courses in medical terminology required or must complete a course within one year of hire date.
3. Post high school courses in coding, health insurance, or office procedures are preferred.

EXPERIENCE

1. PC or word processing experience is required.
2. Medical office or patient access experience is preferred.
3. Switchboard or coding experience is preferred
4. Knowledge of health insurance plans is preferred.

ESSENTIAL PHYSICAL ABILITIES/MOTOR SKILLS

These physical requirements are not exhaustive and additional job-related physical requirements may be added on an as needed basis.  Corrective devices may be used to meet physical requirements.

1. Sedentary Work: Frequently required to stand, kneel and crouch. On a daily basis may be required to move about, sit, climb stairs and bend. Is frequently required to lift and carry up to 20 lbs. May be required to push/pull/carry items between 20-100 lbs.
2. Vision: Requires the ability to perceive the nature of objects by the eye. Near acuity: Clarity of vision at 20 inches or less. Midrange Acuity: Clarity of vision at distances of more than 20 inches and less than 20 feet.
3. Motor Coordination: While performing the duties of the job, it is required to regularly perform functions that include using hand and finger movement, handle or feel objects, be able to use tools or equipment that requires reaching with hands and arms. Must be able to travel independently throughout the hospital; access patients/families including areas confined by space and/or equipment.
4. Speaking/Hearing: Ability to give and receive information through speaking and listening.

ESSENTIAL TECHNICAL ABILITIES

1. Proficiency using modern office, computer and telephone equipment as used by Memorial Healthcare.
2. Ability to enter and retrieve data from computer.
3. Ability to record admissions.
4. Ability to pull required reports for discharges, transfers and admissions.

ESSENTIAL MENTAL ABILITIES

1. Ability to adapt and maintain focus in fast paced, quickly changing or stressful situations.
2. Ability to read and interpret a variety of documents including, but not limited to policies, operating instructions, white papers, regulations, rules and laws.
3. Ability to learn insurance requirements and procedures for admissions/discharges.
4. Ability to perform required switchboard functions.
5. Ability to collect and ask for payments.
6. Ability to learn scheduling procedures for all routine out patients and expand those skills in Ambulatory care and/or surgical setting.
7. Ability to perform simple accounting functions: adding, subtracting, making change

ESSENTIAL SENSORY REQUIREMENTS

1. Able to see for the purpose of reading information received in formats including but not limited to paper, computer, reports, bulletins, updates, manuals.
2. Able to hear for work-related purposes.
3. Ability to accurately hear communication by phone or in person.
4. Ability to respond to codes as needed.
5. Ability to direct phone calls appropriately.

INTERPERSONAL SKILLS

1. Ability to interact with co-workers, hospital staff, administration, patients, physicians, the public and all internal and external customers in a professional and effective, courteous and tactful manner, at all times, physically, verbally and in all written and electronic communication. 2. Required to remain calm when adversity is encountered.
2. Open, honest, and tactful communication skills.
3. Ability to work as a team member in all activities.
4. Positive, cooperative and motivated attitude.