JOB PURPOSE OR MISSION: Provides excellent customer service during the patient access/intake process, executing patient access through the continuum of the revenue cycle that supports efficiency, cost reduction and service improvement. Performs duties according to established hospital procedures for the age population served, as defined in the department’s scope of service.

PERFORMANCE CRITERIA

CRITERIA A: Everyday Excellence Values - Employee demonstrates Everyday Excellence values in the day-to-day performance of their job.

PERFORMANCE STANDARDS:

• Demonstrates courtesy and caring to each other, patients and their families, physicians, and the community.

• Takes initiative in living our Everyday Excellence values and vital signs.

• Takes initiative in identifying customer needs before the customer asks.

• Participates in teamwork willingly and with enthusiasm.

• Demonstrates respect for the dignity and privacy needs of customers through personal action and attention to the environment of care.

• Keeps customers informed, answers customer questions and anticipates information needs of customers.

CRITERIA B: Corporate Compliance - Employee demonstrates commitment to the Code of Conduct, Conflict of Interest Guidelines and the GHS Corporate Compliance Guidelines.

PERFORMANCE STANDARDS

• Practices diligence in fulfilling the regulatory and legal requirements of the position and department.

• Maintains accurate and reliable patient/organizational records.

• Maintains professional relationships with appropriate officials; communicates honesty and completely; behaves in a fair and nondiscriminatory manner in all professional contacts.

CRITERIA C: Personal Achievement - Employee demonstrates initiative in achieving work goals and meeting personal objectives.

PERFORMANCE STANDARDS

• Uses accepted procedures and practices to complete assignments. Uses creative and proactive solutions to achieve objectives even when workload and demands are high.

• Adheres to high moral principles of honesty, loyalty, sincerity, and fairness.

• Upholds the ethical standards of the organization.

CRITERIA D: Performance Improvement - Employee actively participates in Performance Improvement activities and incorporates quality improvement standards in his/her job performance.

PERFORMANCE STANDARDS

• Optimizes talents, skills, and abilities in achieving excellence in meeting and exceeding customer expectations.

• Initiates or redesigns to continuously improve work processes.

• Contributes ideas and suggestions to improve approaches to work processes.

• Willingly participates in organization and/or department quality initiatives.

CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.

PERFORMANCE STANDARDS

• Effectively manages time and resources

• Makes conscious effort to effectively utilize the resources of the organization — material, human, and financial.

• Consistently looks for and uses resource saving processes

CRITERIA F: Patient & Employee Safety - Employee actively participates in and demonstrates effective patient and employee safety practices.

PERFORMANCE STANDARDS

• Employee effectively communicates, demonstrates, coordinates and emphasizes patient and employee safety.

• Employee proactively reports errors, potential errors, injuries or potential injuries.

• Employee demonstrates departmental specific patient and employee safety standards at all times.

• Employee demonstrates the use of proper safety techniques, equipment and devices and follows safety policies, procedures and plans.

JOB FUNCTIONS

ESSENTIAL JOB FUNCTIONS include, but are not limited to:

1. Facilitates patient safety with accurate and timely patient identification.

PERFORMANCE STANDARDS:

• Follows all policies and procedures to accurately identify the patient.

• Prior to obtaining patient ID photo for EMR upload, reviews all patient identifying data with the patient. Does NOT upload ID photos that are incorrect. Updates ID photos if significant change in patient appearance. Places ‘Image withheld at Patient Request’ in patient’s record if necessary.

• Documents in the EMR and communicates timely with treatment team any variation from normal process

2. Timely, accurately and consistently completes the patient access process which may include pre-registration, registration or collections based on the patient’s identified needs at the time service is rendered. 

PERFORMANCE STANDARDS:

• Courteously answers the telephone with approved department script.

• Provides patient and caregivers with appropriate patient intake forms. If necessary, will review and assist patient with completion of the forms and upload into the EMR. Completes account pre-registration, admit or discharge accurately.

• Patient access functions are completed timely, promoting patient safety and minimizing patient delays. Answers calls from guests, patients and MD offices and provides information or referral to another team member as needed.

• Initiates quick registration processes for unscheduled patients, upon request of the clinical staff, when the patient’s care is deemed emergent or urgent.

• Take accurate messages and repeats information to ensure accuracy. Documents all patient encounters in the EMR. Tactfully handles telephone calls in difficult situations.

• Respects confidentiality of information at all times.

• Registers patients to the correct location and treating physician according to information obtained from the Physician’s order, referral form or authorized clinician verbal order which can include but not limited to bed board, case manager, nursing supervisor, patient’s nurse or ED charge nurse.

• Maintains compliance in completing all documents required by specific payers for each patient registration.

• Communicates with Insurance Representatives when necessary to effectively promote continuity in pre-certification/insurance verification process.

• Interrupts insurance verification data as needed and takes appropriate action related to insurance responses.

• Maintains an overall error rate at or below 5%.

• Documents on appropriate form any variation from normal process.

• Performs duties for three areas of responsibility within the Radiation Oncology Department.

3. Computes, requests, collects and receipts monies.

PERFORMANCE STANDARDS:

• Requests current insurance deductible status and coverage limits. Documents according to ROC and BRG policies.

• Accurately creates, extends and deactivates accounts to maintain accurate billing and patient document export to BRG EMR. 

• Accurately maintains and secures all patient financial information in compliance with BRG and ROC policies and procedures.

• Directs patients to locations where deposits/payments to cashier can be made.

• Enters correct procedures and reschedules as needed to ensure patient care and correct billing. Captures correctly from the schedule and procedure information to ensure coding is complete prior to nightly export.

• Researches related accounts’ outstanding debts and discusses with patient as needed.

• Documents any variation from normal process.

4. Performs activation of account according to standard procedures and disseminates chart appropriately. 

PERFORMANCE STANDARDS:

• Completes activation function of all registered or discharged patients facilitating timely patient account functions. Ensures account activation dates coincide with insurance authorization dates and treatment regimen dates and notify supervisor if procedures are scheduled outside of the authorization calendar.

• Disseminates all records and distributes them to appropriate departments/staff according to standard procedures.

• Accurately uploads outside records into the ROC and BRG EMR.

• Documents on appropriate form any variation from normal process.

5. Functions as Lead for patient access/intake process.

PERFORMANCE STANDARDS:

• Acts as lead to other staff when Supervisor or Director is not on duty.

• Makes assignments for all staff in assigned locations, in coordination with PACIII or department leadership.

• Reviews patient accounts and insurance authorization documentation for accuracy on new hires and existing staff as assigned.

• Works at either campus and on varying shifts, based on need.

• Participates on one Quality Improvement / HRT activity per year for the department.

• Participates in daily huddles as assigned by Supervisor or Director.

• Works with Supervisors and Director to ensure adequate staffing based on patient volume and assigned workload.

• To ensure timely and accurate patient billing, assist supervisor and/or director in chart audits as well as reconciling unbilled and denial reports.

• Assists in educating staff on new procedures and/or processes in all patient access areas, or errors in existing processes. 

6. Performs all other duties as assigned.

EXPERIENCE REQUIREMENTS 

Two years experience in Insurance or Patient Registration in healthcare environment required. An Associate or BA degree in a business related may be substituted for experience, as approved by department management.

Customer Services Experience Required. Must possess intermediate computer skills with experience in Windows, Excel, Word and Outlook.

EDUCATIONAL REQUIREMENTS

High School Diploma or GED required, higher education preferred.

SPECIAL SKILL, LICENSE AND KNOWLEDGE REQUIREMENTS

CHAA certification preferred within 6 months of hire.

Must be able to enter data using a computer with multiple applications. Excellent telephone and communication skills. Must possess basic knowledge of medical terminology.

HIPAA REQUIREMENTS:

Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position including but not limited to: medical record without limitation, patient demographics, lab results, patient financial and 3rd party billing information, patient related complaints, information related to patient location.

SAFETY REQUIREMENTS:

Maintains knowledge of and adherence to all applicable safety practices appropriate to Job Position including but not limited to: incident reporting, exposure control plan, hand washing for all age groups.

Full-Time