Description

JOB SUMMARY: Admission Clerks are the first point of contact for medical services to patients at Eastland Memorial Hospital. The focus on excellent customer service and accuracy in the Master Patient Index and Medical Record is priority. The Admission Department comprise of Registration / Pre-Registration, Insurance Verification / Benefit Eligibility, Authorization / Pre-Certification, Medical Necessity and Point of Service Collections for all patient accounts. Admission Clerks have knowledge of patients’ personal information and understands the importance of maintaining confidentiality at all times. One must possess strong communication and telephone skills as well as a comprehensive understanding of the revenue cycle and medical insurance plans. A Clerk must be able to work in a high pressure and sometimes stressful environment and have the sensitivity to deal with patients facing serious health issues.

Requirements

JOB QUALIFICATIONS:

A. Education: High school graduate or equivalent.

B. Personal Job-Related Skills: Must be able to operate the hospital computer systems accurately; be able to read and communicate effectively; have knowledge of general clerical duties.

C. Must be able to work in a fast paced environment; to make independent decisions; and to be flexible in learning styles due to the various department requirements.

D. Licensure, Registry or Certification: None required. CPR preferred.

E. Experience:

1. One year office experience in a health care setting is preferred;
2. Computer skills including the ability to manipulate Excel Spreadsheets and Word Documents are preferred;
3. Other basic office equipment knowledge required.

Physical and Mental Requirements: Duties of the position require intermittent walking, and extended periods of sitting throughout the day; spends majority of time looking at computer screen, entering data, and discussing accounts with staff and customers. Bending, stooping and reaching to retrieve and store records are routine. Duties may require lifting and/or moving up to 10 to 15 pounds. Talking, hearing and visual acuity is a requirement in order to communicate effectively with individuals with various levels of understanding. Exposure to patients and emergency elements are expected.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

This is not intended to be an exhaustive list of all responsibilities and duties assigned to this job classification. Changes and/or additions may be made as needed.

A. Processes patient Registration.

1. Obtains and inputs accurate patient demographic information from patient or responsible party interview;
2. Completes registration record based on orders from a physician or according to EMTALA regulations in the emergency department;
3. Verifies that patient consent forms have been executed by the patient or patient’s representative to release information to file claims for benefits and to consent for treatment;
4. Verifies all insurances, checks medical necessity, checks to see if authorization may be required and contacts ordering physician’s office to obtain authorization;
5. Inputs orders and scans required documents to the patient electronic health record.

F. Secures required deposit and/or insurance information.

1. Copies insurance and id cards, obtains required signatures and uploads to patient health record;
2. Requests and collects co-insurance and deductible amounts and provides appropriate receipts to patient;
3. Makes appropriate financial arrangements if patient is not insured;
4. Refers patients to the Admission Supervisor if payment for charges cannot be made for the required amount to determine alternative.

C. System Input and Report Distribution

1. Inputs accurate patient demographic information following established policies and procedures;
2. Assembles and distributes reports to designated Departments;
3. Assists with distribution of accurate patient information to various physicians and/or clinics;
4. 4. Monitors supplies and submits requisitions as needed.

E. Verify all Patients in Inpatient, Observation, or Swing bed status. Call for authorization if needed . Notify Utilization Review. Enter information into correct folder in Revenue Cycle folder.

5. Reviews all patients that have been admitted into Inpatients, Observation, or Swing Bed status;

6. Verify insurance and determine if authorization is needed. Call for authorization, complete insurance verification form and enter authorization number into visit;

7. Enter all information into Appeals Software and notify UR department;

A. Provide accurate billing information for Motor Vehicle and Worker’s Compensation

1. Reviews all Motor Vehicle and Worker’s Compensation registrations to verify accuracy;

2. Prepare designated forms and obtain clear billing information for claim submission;

4. Provide notification to any outside agencies needed to ensure completeness.

B. Prepares payments received for deposit by Business Office..

1. Reconciles funds received with receipts;
2. Reconciles permanent cash fund;
3. Prepares funds for deposit daily;
4. Maintains cash receipt/cash on hand report daily;

H. Answers, routes, and places calls at the switchboard.

1. Answers each call promptly and courteously;
2. Routes incoming calls to the requested party;
3. Provides clearly written messages to all specified employees when a call cannot be completed;

I. Prepares records for Health Information Management Department

1. Reviews all records for completeness and accuracy prior to release;
2. Complete Check and Balance procedures prior to the medical chart being sent to HIM;
3. Provides records in a timely manner.

J. Follows policies and procedures for infection control and facility safety according to regulatory guidelines.

1. Attends annual health and safety education as scheduled;

3. Observes safety regulations and procedures covering safety related issues;

4. Observes infection control practices at all times.

OTHER SIGNIFICANT REQUIREMENTS:

1. Maintains confidentiality and safeguards patient/hospital related information at all times;
2. Demonstrates behaviors that promote positive customer relations with staff, patients, and visitors;
3. Follows all policies and procedures for the facility in accordance with regulatory guidelines.
4. Completes annual educational requirements and maintains current professional credentials
5. Meets dress code standards for the department and wears identification when on duty
6. Demonstrates behaviors consistent with organizational mission and goals including demonstration dependability and punctuality.
7. Demonstrates knowledge of location and use of fire extinguishers.
8. Interacts positively with customers, taking into consideration any special needs related to age, emotional condition or ability.
9. Accepts assigned duties in a cooperative manner exhibiting acceptable work behavior and conduct.
10. Adheres to department/hospital policies and procedures including consistently demonstrating dependability and punctuality.