Patient Access Services Clerk; Full - time, Day, MMMC

Patient Access Services Clerk; Full-time, Day, MMMC

Under indirect supervision, performs variety of patient registration, telephone, reception and other clerical duties; determines proper financial class; maintains database integrity of systems; maintains quality and professional care of patients requiring medical attention; educates parties regarding business practices and insurance coverage; assists patients/families in meeting their financial obligations.

Essential Responsibilities:

• Greets patients, referring them to appropriate areas of hospital, clinic, or department.
• Alerts medical staff in event of patients with emergent medical problem(s).
• Interviews patient/patient representative(s) and obtains patient data and verifies insurance coverage; obtains demographic and insurance information; obtains medical record number from master patient index if none available. Verify insurance coverage for primary, secondary and tertiary insurance plans.
• Utilizes managed care and other insurance eligibility programs including payor web sites for determining eligibility and coverage, admission notification, and authorization requirements.
• Establishes patient financial class type at point of registration; obtains necessary insurance information; ensures appropriate forms are completed/initiated/routed; photocopies insurance cards, etc.
• Registers patients in KPHealthConnect; enters accurate demographic, financial class, and insurance information; makes revisions to systems database immediately as errors are recognized to ensure database accuracy; documents financial obligations of patients in the appropriate fields in the computer system.
• Processes direct, urgent admissions and coordinates with Nursing Supervisor. Contacts physician for/or receives admitting orders and diagnosis for admission of patient. Creates account for impending admission.
• Communicates deposit requirements to patients and families and documents in KP HealthConnect; refers patients to financial counseling assistance as appropriate.
• Initiates and completes all necessary admitting forms and obtains required signatures in a timely manner; provides explanation for clear understanding; adheres to federal and state regulations, such as Medicare Secondary Payor Questionnaire (MSPQ), during registration process; explains required form.
• Collects cash, check or credit card payments for collectible services; verifies checks have accurate and current information; ensures valid authorization for all credit card payments; validates checks and credit slips; issues receipts; refunds customers for overpayment of services within authorized limits; obtains all appropriate documents and signatures.
• Balances monies, checks, credit card charge documents and daily cash register receipts; reconciles any discrepancies; prepares bank deposit; operates electronic draft capture for charge cards; reconciles and resolves any discrepancies; remits deposit to bank; places change fund order from bank; maintains change fund; buys and sells change from various departments; resolves any balance discrepancies.
• Answers incoming phone calls; transfers calls to appropriate areas of department, clinic, hospital; makes outgoing calls to physicians, payors, etc., as needed.
• Documents pertinent patient account information in KP HealthConnect.
• Provider registration support to other MHS facilities as needed.
• Proactively contacts patients to pre-register them for selected procedures and/or those patients with selected insurance coverages; advises patients of estimated cost share; arranges for deposits/pre-payment prior to procedure in accordance with department protocols and procedures, as needed.
• Prepares and processes daily admission notifications, authorization in a timely manner. Coordinates with financial and clinical staff for timely updates and communication.
• Prints Pre-census Report nightly; verifies census with Nursing Units. Assigns accommodations/bed assignments as directed for patients by evening/night supervisors. Compiles daily census information.
• Receives, records, accounts for and releases patient valuables left for safekeeping. Notifies and coordinates with Social Services department.
• Provides appropriate patient information to physicians, relatives and visitors of patients.
• Performs variety of patient services such as providing information or explanation of problems pertaining to benefits, eligibility, etc.
• Handles patient problems; refers difficult patients to supervisor, Patient Advocate and/or Security when necessary.
• Immediately reports prankish, threatening, disaster alert or emergency situations to supervisor as well as any peculiarity which may jeopardize or endanger any member of staff or employee, patient, visitor or employer facilities.
• Performs other duties and accepts responsibility as assigned.

Basic Qualifications:

• Experience: N/A
• Education: High school diploma GED, or equivalent.
• License, Certification, Registration: N/A

Additional Requirements:

• Previous office/clerical experience.
• Demonstrated knowledge of and skill in customer service, oral communication, and written communication.
• Demonstrates knowledge, skills, and abilities necessary to provide culturally sensitive care and/or service.
• Talking to co-workers, customers, outside vendors, and on the telephone.
• Reading, writing, speaking and understanding English.
• Training/giving and receiving instructions.
• Mathematical ability, attention to detail (e.g. organization, prioritization, proofing), concentration and alertness.

Preferred Qualifications:

• Demonstrated knowledge of and skill in word processing, spreadsheet, and database PC applications.
• Six months medical front office experience
• Demonstrated knowledge of and skill in customer services (e.g. AIDET).
• Demonstrated working knowledge of medical terminology.