Memorial Health Care Center Patient Access Clerk in Owosso, Michigan
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. He/She is responsible for interviewing and gathering of complete and accurate data to complete the admission/registration process accurately, efficiently, and expeditiously. The Registration 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/guest, of hospital regulations, policies and services. Determines medical necessity on each physician order by assuring all essential elements are present on each order. Is responsible for assuring an ABN is assigned when procedures ordered do not meet Medicare guidelines. Explains Medicare guidelines to the patient and obtains appropriate signatures to assure payment for those services that are determined to have a high likelihood of denial. Upholds the mission and values established by Memorial Healthcare.
II. Job Relationships
Responsible to: a. Supervisor of Patient Access b. Director of Revenue Cycle
Workers Supervised: None
Interrelationships: Deals with the public, primarily patients and their families. Has contact with physicians and their office staff, visitors and all other departments and volunteers.
III. Job Responsibilities
A. Primary Job Responsibilities:
Interviews patients courteously to obtain accurate data to admit and register patients.
Receives admission information from physicians and their offices, the Emergency Room and patients boarded for surgery.
Maintains an updated daily census, available room accommodations, and any patients assigned to those rooms.
Maintains a log for any patient expirations.
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.
Uses Meditech computer system to register all patients.
Directs all outpatients to proper ancillary department.
Receives discharges, transfers and other changes from Patient Care Staff via hospital computer system. Maintains these reports in order to keep an updated patient census.
Completes work within authorized time to assure compliance with departmental standards.
Maintains confidentiality of all information.
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.
Maintains a well-organized and clean environment to work at maximum efficiency and prevent transmission of infection and disease.
Crosstrains within the department to effectively handle the functions of pre-admission, admission, outpatient registration, emergency registration, scheduling, cashier, verification and switchboard.
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.
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 patient's agreement to pay for said services.
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.
Represents Memorial Healthcare as the welcoming official to all patients and/or visitors in Admitting/Patient Registration, the Emergency Department, and Communications.
B. Other Job Responsibilities
Performs as Communication Clerk as required.
Is willing to crosstrain for other jobs within the department.
IV. Job Specification
A. Education: High School diploma required. Post high school courses in Medical Terminology required or must complete within one year of hire date. PC or word processing experience required. Post high school courses in coding, health insurance, or office procedures preferred.
B. Training & Experience: PC or Word Processing required. Medical office or patient access experience preferred. Switchboard or coding experience preferred.
C. Job Knowledge: Knowledge of health insurance plans preferred. Must be proficient in Customer Service. Must be able to use office equipment.
V. Essential Physical Requirements: Able to travel independently within department confined by space and equipment and within hospital, to obtain consent and insurance form signatures.
VI. Essential Mental Abilities: Able to learn insurance requirements and procedures for admissions/discharges, switchboard and cashier. Mastery of basic math skills. (simple accounting, adding, subtracting, and making change.) Must be able to learn scheduling procedures for all routine out patients and be able to expand those skills into the Ambulatory Care and/or Surgical setting.
VII. Essential Technical Motor Skills: Ability to enter and retrieve data from computer, record admissions on census and patient transfer listing and also record miscellaneous changes.
VIII. Essential Sensory Requirements: Ability to communicate with patients to verify patient admission and insurance information, to respond to codes, and direct telephone calls appropriately.
IX. Interpersonal Skills: Ability to interact well with patients, their families, the public and physicians and other staff.