PATIENT ACCESS REP III Kona Health Center

LOCATION : KONA HEALTH CENTER

POSITION STATUS : 1.00 | Temporary

SALARY RANGE : BU00

SALARY RATE: $50,652.00 (Annual Salary) based on the Full-Time Employment

JOB DUTIES :

PREADMISSION/ADMISSION OF PATIENTS

• Ensures inpatient admissions are completed, insurance verified and pre-authorizations obtained regulated consents are signed, within 24 hours of admission.
• Ensures that all next day scheduled appointments are pre-registered, information verified, and preauthorization/precertification acquired and all self pay accounts are passed onto financial counselors or patient advocate within 24 hours of scheduling.
• Communicates daily with patients and insurance companies to validate information including demographic, insurance, financial and other pertinent data.
• Obtains insurance verifications of benefits and eligibility.
• Ensures patients are aware of third-party payer requirements.
• Audits accounts to maintain 100% accuracy rate for demographic and insurance information.
• Coordinate accurate data to determine financial obligation based on policies including collection of insurance co-payments, self pay deposits and patient balances.
• Communicates with hospital personnel, medical staff, patients, family members and outside agencies to insure quality patient care.
• Assists in training new employees; reviews the work of lower level Patient Services/Access Representatives for completeness, accuracy and adherence to applicable polices and procedures.
• Interviews patients or their representatives and obtains demographic and primary and secondary insurance information.
• Researches and update 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 recognizing that these documents constitute a medico legal document.
• 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.

INSURANCE VERIFICATION - POINT OF SERVICE CASH COLLECTIONS

• 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 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.
• Addresses error resolution with the appropriate Patient Access staff for improved future results.
• Responsible for daily reconciliation of cash collections and reviewing daily cash journal report for accurate collections.
• 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.
• Refers to disaster procedures and promptly notifies key hospital personnel of an anticipated/actual disaster.
• Participates in County Civil Defense exercises and dry-runs.
• 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

• Updates the IBAX hospital patient data base system to reflect transfers, bed swaps, and discharges at the direction of the nursing units.
• Ensures that admitting and census statistics are accurate, as required for various agencies such as the Department of Human Services and Medicare and for hospital administration, on a monthly basis.
• Assists in the training of new employees on all functions
• Administers, monitors and audits hospital key control system. Maintains key safe.
• Receives all returned patient statements, obtains correct mailing address and forwards 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. The Joint Commission, 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.

Other information:

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.

SPECIALIZED EXPERIENCE: Two (2) years of work experience performing admission activities in a hospital; interviewing patients and/or responsible persons to secure information, securing signatures for insurance benefits; arranging for method of payment for costs not covered by insurance; and preparing admitting records.

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: Patient accounting operations, registration and standard intake techniques. Third party payor requirements, credit and collection practices. Federal regulations including Consolidated Omnibus Budget Reconciliation Act (COBRA), Advance Directives, Medicare, Medicaid, Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Occupational Safety and Health Administration (OSHA) and Health Insurance Portability and Accountability Act of 1996(HIPAA) as they relate to hospital intake and payment for services. Customer service philosophies and practices. Knowledge of financial policy and deployment of practices used within the department as well as the business office to resolve the patients’ accounts.

ABILITY TO: Prioritize work demands and work with minimal supervision; communicate effectively both verbally and in writing; and maintain confidentiality relevant to sensitive information. Ability to generate reports and provide accurate statistical data; review the work of subordinates and train new employees. Make arithmetic computations; compare names and numbers rapidly and accurately; type at the rate of 40 WPM and be computer literate 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; 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; 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.