JOB SUMMARY:
- Performs quality assurance audits ensuring completeness and accuracy of registrations in compliance with policies and procedures. Error reporting is submitted on a weekly basis with analysis of error trends by error type and employee along with error rates by type and for the department. Details of each area will accompany the reporting to be provided to the PAS Management team. Reviews and checks that the following criteria are correct and is accurately reflected in the system: patient’s spelling of name, patient’s/insured’s date of birth, patient’s address, patient’s social security number, insurance/payor code, financial class, guarantor information, billing address, policy number, group number, documentation of verification, and release of verification. Be able to conduct root cause analysis of common error trends for process improvement purposes. Complete PAS projects and conduct employee training as required.
EXPERIENCE/QUALIFICATIONS:
- Must have at least 2 years of patient access/ hospital registration experience and have consistently met or exceed quality and productivity standards.
- Must demonstrate expert level knowledge in Patient Access workflows, policies, procedures and insurance payors.
- Must have experience in Patient Access quality review processes.
- Must function efficiently and independently.
- Must be able to display and analyze large volumes of data into meaningful reports.
- Strong interpersonal, written and oral communication skills for interacting with patients, payers, physicians and other customers.
- Strong knowledge of Meditech and other information systems (Excel, Word, Visio and Powerpoint, etc.).
EDUCATION:
- High School graduate or equivalent
- College Degree and/or Certified Patient Account Technician certification, medical terminology course, management courses a plus
LICENSURES/CERTIFICATION:
- Must successfully complete and maintain LA City Fire Card certification at the time of hire or within the first 30 days of employment
- Must successfully complete and maintain certification for VPH CPI- Non-violent Crisis Intervention within 30 days of employment.
DUTIES AND RESPONSIBILITIES (These are the essential job functions for this position. The essential functions of this job include, but may not be limited to those listed in this job description. Employees hired for this position must be able to perform the essential function of this job without imposing significant risk of substantial harm to the health or safety of themselves or others):
- Responsible for ensuring completeness and accuracy of registrations
- Reviews insurance cards and updates all financial data in the patient account correctly
- Properly appropriates the correct payor, financial class, and billing information for each registered account
- Documents notes to billing that are pertinent to getting claims paid
- Helps in registration with lunch breaks and accounts when needed
- Identifies the payor source, verifies insurances for all payors and documents if the information is missing/not documented in Meditech
- Correct and report errors back to supervisor/manager and reports the error rates for improvement and Performance improvement opportunities.
- Monitors and gives feedback on recurring issues to improve processes
- Provides training and in-services employees as needed
- Helps compile data to improve accuracy and error rates
- Maintains a professional atmosphere in the department and works together in a spirit of teamwork
- Responds to patients in a courteous and respectful manner
- Answers the telephone in a prompt, courteous manner identifying their name, and department they are working in
- Extends special attention and sensitivity to all patients, visitors, physicians, and fellow employees
- Assists in maintaining an atmosphere of cooperation with other departments and allied professionals
- Demonstrates the ability to participate in and/or implement team decisions
- Demonstrates the ability to adapt to varied age-specific patient populations
- Maintains confidentiality regarding patient/employee/facility information 100% of the time
- Attends all hospital mandatory in-services on a timely basis as scheduledSubmit weekly and monthly reporting to identify trends by employee, error type with error rates by the 5th working day of each month for the prior month.
- Participates as an active team member at all staff meetings
- Reads all communications and acts upon in a positive and informative manner
- PAS project management
- PAS and Financial Counseling Training as required.
- Other duties as assigned
The following job accountabilities are not unique to this particular job but are common to all jobs at VPH:
Complies with VPH policies and procedures on customer satisfaction and service excellence. Demonstrates professionalism and cultural sensitivity in coordinating activities and communicating with all customers, peers, and the community at large. Conducts self in a professional, respectful and courteous manner during all interactions. Works effectively and collaboratively with others toward common goals.
Communicates accurately, honestly, supportively and in a timely manner with department and interdepartmental team members. Demonstrates effective business writing and oral communication skills, handwriting is clear and legible.
Participates in operational aspects of the department, and maintains/participates in performance improvement activities within the department.
Participates in all departmental specific training, Environment of Care (injury/illness prevention, fire/life safety, hazardous materials, emergency preparedness, utilities management, medical equipment management, safety and security management), infection control (standard precautions, TB Exposure Control Plan, Bloodborne Pathogen Exposure Control Plan).
Demonstrates knowledge of and follows safety practices. Understands the importance of safety, including patient safety in the work place. Maintains a safe environment for self and others.
Actively participates in the Patient Safety Program, including event reporting. Identifies sentinel events/near misses and responds per defined organization processes. Participates in education activities and process implementation. Demonstrates advocacy for the patient/customer and appropriately acknowledges patients, customers and visitors.
The above statements reflect the essential functions considered necessary to describe the principle content of the job. They are not intended to be a complete statement of all work requirements or duties that may be inherent in the job.
WORK ENVIRONMENT:
- Primarily an inside building/office environment, well lighted and ventilated, which may consist of multiple treatment and/or work sites.
- Fast and continuous work pace with variable workload.
- Frequent contact with staff and public under a variety of circumstances. Requires ability to communicate clearly (in English) verbally and in writing for effective communication with other staff members, physicians, vendors, community members, patients and patient families, employees and applicants of all socio-economic levels from a diverse cultural and ethnic population.
- Subject to many interruptions from multiple calls and inquiries and potentially emotional situations involving accidents, injuries, illness and/or death.
- Handles emergency/crisis situations in accordance with Hospital policy.
- Answers phones or pages; may carry a beeper/pager, and/or use a two-way radio.
- Occasional travel may be required.
- Potential risk of exposure to hazards from chemicals (toxic and non-toxic), flammable materials, gas or electrical or radiant energy or equipment with/without moving parts.
PHYSICAL DEMANDS:
Key for Physical Demands
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Continuous
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66 to 100% of the time
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Frequent
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33 to 65% of the time
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Occasional
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0 to 32% of the time
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Clerical/Administrative Non-Patient Care
- Frequent/continuous sitting with occasional, intermittent standing/walking.
- Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and chest level.
- Occasional/intermittent reaching at or above shoulder level.
- Occasional/intermittent bending, squatting, kneeling, pushing/pulling, twisting and climbing.
- Occasional/intermittent lifting and carrying objects/equipment weighing up to 25 pounds.
- Continuous use of near vision, hearing and verbal communication skills in handling telephone calls, interacting with customers and co-workers and performing job duties.