Patient Access Rep I

LOCATION : KONA COMMUNITY HOSPITAL | General-Rural Health Clinic

POSITION STATUS : 1.00 | Temporary

SALARY RANGE : BU00 | SR11

SALARY RATE: $43,272.00 (Annual Salary) based on the Full-Time Employment

JOB DUTIES :

INSURANCE VERIFICATION – POINT OF SERVICE CASH COLLECTIONS

• Reviews patient demographic information collected through the preadmission, admission, or registration process for accuracy.
• Contacts insurance carriers to obtain benefits and eligibility for the specific insurance plans.
• Utilizes electronic media for validating insurance plan codes, certificate numbers and expirations of coverage.
• Validates the certificate numbers for each insurer/subscriber.
• Enters the subscriber verification information in the IBAX hospital patient data base system.
• Updates patient record with specific changes required prior to bill production.
• Conducts precertification when necessary in order to ensure coverage for services.
• Refers continued stay certification to the Utilization Review Coordinator when information is needed beyond what the Patient Access Department can provide.

PREADMISSION/ADMISSION OF PATIENTS

• Interviews patients or their representatives and obtains demographic and primary and secondary insurance information.
• Updates previous records within the information system OR enters information to create a new file.
• Notifies appropriate hospital personnel of new registrations so that admitting orders can be obtained.
• Explains hospital policies regarding room accommodations and visitors.
• Discuss and determine method of payment with the patient and/or responsible party, collects deposits, and acquires signatures on all pertinent forms.
• Initiates and accurately completes all necessary admitting forms.
• Prepares an addressograph plate showing pertinent patient information by utilizing an electric plastic plate embosser.
• Prepares a patient wristband and attaches the wristband to the patient.
• Assigns the patient a bed taking into consideration the needs of the patient, special orders written by the admitting physician, and unit availability.
• Directs the patient to the assigned nursing unit and forwards all pertinent documents with the patient or escorts patients in need of assistance.
• Inputs additional information into the system as directed.
• Complies with rules, regulations, rights and statutes of State, Federal, hospital and hospital regulatory agencies.
• Calculate, obtain and process advance cash and credit deposits.
• Works closely with billing department to resolve all billing/collections issues.

SWITCHBOARD COVERAGE/CENTRAL COMMUNICATIONS

• Answers and refers incoming calls to the proper department of person.
• Maintains a record of all toll calls and places emergency calls for the medical staff or nursing. Main information clerk for entire hospital and/or receptionist for Patient Access.
• Makes special announcements over the PA system/Radio and pages the medical staff and hospital personnel as needed.
• Announces fires, disasters, or drills to all hospital personnel over the PA system.

5.Participates in County Civil Defense exercises and dry-runs.

• Refers to disaster procedures and promptly notifies key hospital personnel of an anticipated/actual disaster.
• Refers employee sick calls to the respective department head.
• Assists in the notification of on-call personnel.
• Maintains a daily sign in/out sheet of on call personnel that are on property.
• Monitors emergency systems (fire, nitrogen, oxygen, lifeline) and serves as communications control.

OTHER UNIT RESPONSIBILITIES

• Distributes the pre census and census daily for update by nursing personnel.
• Updates the hospital patient data base system to reflect transfers, bed swaps, and discharges at the direction of the nursing units.
• Assists in computing and maintaining admitting and census statistics as required for various agencies such as the Department of Human Services and Medicare and for hospital administration on a monthly basis.
• Distributes copies of admission summaries to departments and physicians.
• Assists in the training of new employees on all functions.
• Process and distribute incoming/outgoing mail. Receives courier deliveries when Storeroom is closed. Receives all returned patient statements, obtains correct mailing address and forwards statement to patient
• Communicates and interacts with patients, families and other staff members in a positive and courteous manner.
• Compliance with mandatory in-service requirements, e.g., patient rights, crisis prevention, annual mandatory health and safety, etc.
• Maintains the strictest confidentiality of all facility and facility related employee/ patient information.
• Participates in activities of department, i.e. JCAHO, Safety, Performance Improvement, and Infection Control.
• Adheres to hospital rules and regulations, and policies and procedures.
• Plans and organizes workload and is aware and flexible to acute needs of the section.
• Considers age-specific needs when serving or assisting patients:

___ Infants (0-2 years) ___ Adults (19-70 years)

___ Pediatrics (3-12 years) ___ Older Adults (greater than 70)

___ Adolescents (12-18 years)

• Uses knowledge of different cultures when interacting and assisting patients.

Performs other related duties as assigned.

THE MINIMUM QUALIFICATION REQUIREMENTS ARE: Applicants must meet all of the following requirements. Please note that unless specifically indicated; the required education and experiences may not be gained concurrently. In addition, qualifying work experiences are based on a 40-hour work week.

EDUCATION REQUIREMENT: High school diploma or equivalent.

GENERAL EXPERIENCE: Two (2) years of typing, stenographic, clerical work, cashiering, data input, customer service skills or any combination of these experiences which duties demonstrated knowledge of English grammar, spelling, arithmetic, standard office equipment; and the ability to read and understand oral and written instructions, carry out procedures in clerical work systems, speak and write simply and directly, observe differences in copy and proofread words and numbers quickly and accurately, and operate various kinds of office equipment; and ability to deal effectively with others in eliciting information and providing service.

SUBSTITUTION OF EDUCATION FOR GENERAL EXPERIENCE: An Associate’s or Bachelor’s from an accredited college or university may substitute for all of the General Experience required.

QUALITY OF EXPERIENCE: The number of years of experience required for any grade level represents the minimum amount of time necessary to qualify for the appropriate position, but length of time is not in itself qualifying. The applicant's work experience must also have been of a quality and scope sufficient to enable them to perform satisfactorily assignments typical of the grade level for which they are being considered.

KNOWLEDGE AND ABILITIES REQUIRED:

KNOWLEDGE OF: Office practices and procedures; grammar, spelling, punctuation and work usage; use of standard office machines; techniques of interviewing others to obtain pertinent information.

ABILITY TO: Make arithmetic computations; compare names and numbers rapidly and accurately; type at the rate of 40 words per minute and be computer knowledgeable in a windows based environment; operate a telephone switchboard, teleprocessing terminal, and inter-communication system; file materials numerically and alphabetically; follow oral and written instructions; accept and follow instructions; cooperative, communicate positively and effectively with staff, patient and patient family; work harmoniously with others; understand, explain and apply policies, procedures, rules and regulations pertinent to the admission of patients to an acute, skilled nursing or outpatient hospital or outpatient procedure; keep matters confidential; interview others to obtain pertinent admissions information; ability to speak and write English.

ALL CIVIL SERVICE JOB VACANCIES WILL BE POSTED FOR A MINIMUM OF TEN (10) CALENDAR DAYS

The Hawaii Health Systems Corporation is an equal opportunity employer and complies with applicable state and federal laws relating to employment practices

QUALITY OF EXPERIENCE: Possession of the required amount of experience will not in itself be accepted as proof of qualification for the position. Overall paid or unpaid experience must have been of such scope and responsibility as to conclusively demonstrate that you have the ability to perform the duties of this position. Provide a detailed description of your duties and responsibilities. If you worked on a part-time basis, indicate the average number of hours worked per week. Please note that experience will be based on a 40-hour workweek. Note: We will not postpone the recruitment process because of your failure to provide accurate and complete information concerning your qualifications.

MERIT OR CIVIL SERVICE SYSTEM: You must meet the minimum qualification requirements, including education, experience, other public employment requirements for State Civil Service employment, and HHSC Standards of Fitness. Only those applicants that are scheduled for an interview with the hiring manager will be contacted.

CITIZENSHIP AND RESIDENCE REQUIREMENT: Applicants must be a citizen, national or permanent resident alien of the United States or a non-citizen eligible under the federal law for unrestricted employment and at the time of appointment intend to reside in the State of Hawaii during the course of employment with the Hawaii Health Systems Corporation.

VETERAN’S PREFERENCE: If you are claiming Veteran’s Preference, you must submit a copy of your DD214 and/or other substantiating documents specifying the periods of your service.

HEALTH AND PHYSICAL REQUIREMENTS: Applicants must meet the health and physical requirements deemed necessary to effectively and safely perform the essential functions of the position with or without reasonable accommodation. Hawaii Health Systems Corporation is committed to making reasonable accommodations on a case-by-case basis. Applicants seeking reasonable accommodations should be ready to discuss the accommodation sought so that a determination can be made that such accommodation is reasonable and would not cause the employer undue hardship.

MEDICAL/PHYSICAL EXAMINATION REQUIREMENT: Offers of employment will be contingent on successfully passing a pre-employment physical examination, which includes drug screen and other regulatory medical requirements such as, but not limited to, two-step tuberculosis (TB) screen. The cost for physical examinations, except the cost for drug screening, shall be borne by the applicant and not the Hawaii Health Systems Corporation.

CRIMINAL/BACKGROUND, CREDENTIALING CHECKS: Applicable checks will be conducted periodically, and any associated costs may be borne by the applicant. Applicable checks may include, but are not limited to, state and federal criminal history records, child abuse and neglect registry check, adult protective services registry and sex offender registry records, etc. If a job offer is made or employment is begun prior to completion of all applicable checks, any offer of employment or continued employment is contingent upon satisfactory return of all required checks.

IMPORTANT APPLICATION/EMPLOYMENT INFORMATION