Munson Healthcare Patient Access Representative in Grayling, Michigan
Job Summary: Performs all duties related to registration, pre-registration, scheduling of ancillary testing and procedures, insurance verification and pre-certification while using multiple programs and resources. Works under conditions of constant interruptions and subject to extreme time pressure and changing requirements.. Must be able to utilize the telephone and perform switchboard functions.
Minimum Requirements: High school education or GED equivalent. At least 1 year experience successfully working with the public with minimal supervision. Proven ability to communicate effectively with both public and co-workers orally and in writing, and posses the ability to work positively with all levels of clinical staff in completion of job responsibilities. Must be computer literate and posses a proven ability to effectively use multiple computer systems. Successful completion of a medical terminology course required within 6 months of hire date. Experience with Blue Cross, Blue Shield, Medicare, Medicaid, Commercial and any other insurance coverage's preferred. BLS/CPR within 6 months of hire.
Skills, Talents and Abilities: Ability to interpret large amounts of data, able to problem solve and demonstrate critical thinking skills. Strong organizational skills required and ability to concentrate while subject to multiple interruptions. Must be constantly discerning and sensitive to the needs of the patient and/or their family members and provide communication appropriately. Must determine most effective means of dealing with patients/families with varying attitudes and problems. Must exercise patience and tact in dealing with all levels of personnel throughout Munson Healthcare Grayling Hospital. Exercises high degree of control over confidential information. Interprets priority of work activity based on patient requirements and departmental needs. Demonstrates excellent customer relations behavior in all interactions. Must have ability to exchange all information with all customers in a kind and friendly manner.
Professionally greet ALL customers entering the hospital.
Maintain positive interpersonal relations in dealing with patients and their families so that patients perceive a positive experience, which includes dissemination of information, resolving customer complaints, and routing patients to their destination
Demonstrates positive interpersonal relations in dealing with co-workers, physicians, physician's office staff, and other members of the health care team to achieve optimal customer service, departmental goals, efficiency, collegiality, Mercy values and quality care. Demonstrates ability to provide information, guidance, and assistance to patients and visitors.
Maintain knowledge of paging systems, emergency systems, and has the ability to respond to all codes within the facility.
Monitor the main entrance floors and parking lots and contact Maintenance or Environmental Services when necessary
Maintain, stock, and care for departmental equipment and supplies.
Resolve customer complaints or escalate to appropriate person.
Maintain proficiencies in all computer applications currently in department use.
Perform order entry and activation through PowerChart
Work closely with physician offices to obtain accurate orders and diagnoses for outpatient testing.
Coordinate with case managers, physician offices, ancillary departments and insurance company requirements for reimbursement
Verify patient insurance coverage and benefit eligibility via appropriate system with insurance companies. Communicate with patient and physicians office when scheduled ancillary testing is not covered by insurance or when patient is not eligible.
Use Compliance Checker programs to screen for medical necessity and to determine need of advanced beneficiary notice (ABN).
Determine co-pay and deductible information from insurance eligibility and coverage inquiries
Demonstrate ability to accept payments from patients, record and issue receipts.
Recognize self-pay accounts and collects payment or makes referral to appropriate Financial Counselor.
Demonstrate ability to scan medical record chart and index appropriately.
Independently identify accounts that need more attention and independently identify methods for resolving difficult accounts.
Assist in the development and maintenance of departmental policies and procedures
Communicate with Central Scheduling to adjust schedule changes ï¿½ i.e., cancellations, no shows and re-scheduled visits and walk-ins.
Provide staff coverage and maintain proficiency in Lab and Pre-Admission testing.
Demonstrates ability to maintain department records, reports and files as required.