Patient Access Services Coordinator - 40hrs/Day Shift

• High school diploma or equivalent required

• One (1) to three (3) years of administrative and in-person customer service experience required

• Rehab office coordinators, front desk doctor's office, and patient access services experience preferred

• Familiarity with and understanding of hospital admissions, patient account systems, and major health insurers and general coverage issues preferred; previous cashiering experience preferred

• Demonstrated typing proficiency, personal computer, and CRT experience required

• Tempus One Scheduler experience andnmedical terminology preferred

• Demonstrated interpersonal, oral, and written communication skills required

ESSENTIAL JOB FUNCTIONS:

• Interview incoming patients, or their representative, to obtain all pertinent and financial information required for the proper preparation of all forms and records. Obtain required signatures on the financial agreement's form, HIPAA forms, and cancellation policy.

• Work productively with all members of the Rehab Services Team. Develop, accept, and contribute to all goals and objectives established by the department.

• Perform admitting duties and register patients via hospital computer system. Enter daily orders/charges on each outpatient and inpatient as required. Receive orders from patient care units and respond accordingly.

• Perform scheduling duties. Receive referral information from patients, their representatives, visiting nurse associations, physician's office support personnel, and therapists. Schedule patients according to current systems and keep all systems and involved parties up to date throughout the process. Track cancellations and no-shows.

• Interact effectively with patients and doctors' offices in order to gather correct, complete data necessary to ensure that clinical and fiscal responsibilities are facilitated, for both the patient and the hospital. Follow manual procedures when computer system is not functioning properly.

• Schedule all patients' appointments via the Scheduling System. Notify physician's offices and insurance companies if a prior authorization is required. Educate patients and their representatives about insurance authorizations as needed. Follow insurance guidelines and keep up to date with all insurance requirements and stipulations in order to obtain reimbursement. Keep all clinicians informed of their patient's appointments and insurance information.

• Call patients at home to verify information prior to admission as needed and call physician's office if a patient has not arrived for their therapy visit.

• Stay current with new outpatient therapy regulations of the many public and private insurance companies that patients carry, such as Medicare, Blue Cross HMOs, Health New England, Tufts, Worker's Comp, and Liability - pre-authorization approval guidelines. Utilize Eligibility checkers such as Emdeon, MediFax, NEHEN and various websites. Follow guidelines in order to attain the appropriately benefit, eligibility, and co-payment information and update the hospital-based computer system accordingly.

• Recognize and take action when a patient is scheduled inappropriately or does not follow necessary procedures so as not to leave the hospital at a financial risk. Determine which insurance plan is to be billed as primary or secondary. Receive correct guarantor information.

• Explain, over the phone and in person, hospital and insurance regulations relating to therapy, such as co-payment amounts, deductibles, and other related issues to patients as necessary, keeping as transparent as possible. Listen to complaints and concerns of patients and the public, assisting to solve problems.

• Transmit required information to appropriate departments. Use auto-attendant phone system, page physicians, therapists, supervisors, department head, and technologists and park calls as needed.

• Provide patient information in accordance with regulations governing divulgence of information (HIPAA).

• Distribute federal and state-mandated information to patients.

• Verify benefits on all designated patient types. When necessary, assist with pre-certifications with insurance carriers. Notify patients and/or appropriate medical personnel of outcome.

• Maintain confidentiality of all patients' records and data. Interface with medical records and billing department as required based on department, hospital, and patient care needs.

• Requisition office supplies and forms when necessary.

• Cross train and work a flexible schedule as needed, working in other satellite facilities such as Amherst, Southampton, Northampton, South Deerfield, Hatfield, and Worthington.

• Maintain established hospital and departmental policies and procedures, objectives, confidentiality, quality improvement program, compliance, safety, infection control, and environmental standards.

• Maintain professional growth and development through attendance at seminars, workshops, conferences or in-services, professional affiliations or journals to stay abreast of current trends in field of expertise.

• Meet annual competency and retraining requirements.

• Attend meetings as required.

• Perform other functions/duties as requested.