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|Job Category :||Business|
|Company Name:||MEDSTAR HEALTH|
|Position Name:||Patient Financial Assoc|
|Location :||3800 Reservoir Rd. NW, Washington, DC 20007|
|Job Description :||Job Summary
The individual in this position provides assistance in supporting all the functions and activities related to patient access in the department including, but not limited to, front end customer service, accurate patient registration in the approved organization electronic scheduling and billing systems, on-site insurance verification and financial counseling, accurate Time-of-Service (TOS) payment collections and interfacing with health care team. These functions are performed in accordance with Georgetown University Hospital’s (GUH) philosophy, policies, procedures and standards.
CONSIDERATION WILL BE GIVEN TO AN APPROPRIATE COMBINATION OF EDUCATION/TRAINING AND EXPERIENCE.
High School graduate. Associate degree preferred.
Three years experience in a medical/clinical office required. Previous experience with computerized registration systems and supervisory experience strongly preferred. Working knowledge of IDX / GE Centricity Business and SMS/Invision preferred.
Knowledge, Skills & Abilities
Fluency in Medical Terminology required; fluency in Spanish preferred; Effective interpersonal & communications skills, as well as good telephone etiquette; high level of competence in customer relations in a professional environment; ability to prioritize, organize work and be self directed; ability to work as a member of a team; ability to work in stressful situations; good problem solving skills. Ability to perform in a high pressure environment. Ability to deal effectively and professionally with a variety of different individuals
Primary Duties and Responsibilities
Registers patients using the approved organization electronic registration and billing systems. Follows guidelines to avoid duplicate medical record assignment. Obtains and/or verifies complete demographic and insurance information from patient. Accurately enters complete demographics, insurance information and Financial Status Classification (FSC) / Hospital Patient Accounting Plan Code assignment. Obtains and scans relevant documents such as consent to treat, face sheets, etc., as necessary for accurate registration.
Performs the patient registration process, including adherence to all established policies and procedures related to querying the Enterprise Access Directory (EAD) and obtaining complete demographic and insurance information for each patient account.
Performs the pre-registration process, including staff adherence to all established policies and procedures related to determining and accurately creating appropriate accounts with the correct provider, referral and/or authorization requirements, procedure orders, and other account specific requirements.
Works in the bed tracking requirements for scheduled admitted patients, scheduled surgical cases, procedures and emergency admissions for the department, including staff adherence with GUH procedures and appropriate communication of GUH facilities, policies and instructions to patients and families.
Registers patient accounts using the approved organization electronic registration and billing systems, entering all required data elements as dictated by the Georgetown Physicians Group (GPG), GUH and departmental policies and procedures. Identifies patient’s insurance, ascertains GPG and GUH contract participation status (Par vs. Non-Par) and communicates contract participation status to patient.
Answers incoming calls for hospital and in-house information regarding services, general information, etc.
Performs patient check-in and registration process for department including patient reception, validation of patient identity, scanning of patient documents to the appropriate system, resolution of all missing or inaccurate information prior to patient arrival and insurance verification.
Ensures accurate review, follow up and completion of the approved organization electronic registration and billing system standard and custom reports, including temporary accounts with charges, pre-admits, managed care and health information management reports, in conjunction with the Patient Access, Team Lead, Patient Access Manager and/or Department Director,
Checks patients in, completing all required steps including validating patient identity, scanning required documents, resolving all outstanding issues, collecting POS payments, and documenting appropriately. Communicates patient’s arrival to appropriate clinical staff.Arranges for transportation when necessary.
Referrals, Pre-certification and Authorization Process
Participates in the referral, pre-certification and authorization process for department including staff adherence to all GPG, GUH and Managed Care Department requirements and contracts to ensure all financial obligations are met before services are rendered. Determines in conjunction with the Clinical department and provider if an appointment can be rescheduled if there is a missing referral, pre-certification, or authorization.
Responds to communications with Pre-certification department, patients and providers regarding eligibility verification, benefits and deductible status, and authorizations for office-based and Hospital services, procedures and admissions. Ensures that eligibility and applicable authorizations are obtained prior to services being rendered for any and all accounts not previously verified through the Pre-Certification Office of the CBO.
Obtains documentation of referrals and authorizations in the approved organization electronic registration and billing systems, Documents in Patient Accounting system to be utilized by all connected departments.
Participates in the training and education of staff on managed care contracts and processes, system utilization of the approved organization electronic scheduling and billing system, Joint Commission (JC) standards, and Health Insurance Portability and Accountability Act (HIPAA) privacy guidelines and compliance issues.
Verifies eligibility and conformance to GPG, GUH and departmental managed care requirements and contracts. Educates and informs patients and families regarding verification status and issues related to deductibles, co-payments and balances. Responds to hospital staff and/or patient inquiries regarding referrals, authorizations and scheduling in an efficient manner.
Patient Health Records & Information Technology
Adheres to GPG, GUH and departmental policies and procedures, will access patient Medical Records / Electronic Health Records (MR/EHR), for work related activities only, to complete proper patient documentation in the health record or to view needed information in the patient chart as necessitated by job role or function. Adheres to most current work flows or processes developed within GPG or department.
Expertise in all relevant technologies necessary to manage Patient Access department, including SMS Invision, IDX/GE, Azyxxi, Teletracking, HDX, PICIS, etc.
Successfully completes the training, competency and support of applying and utilizing the enabling technology for Patient Access services
Monitors clinical facility needs and space to ensure a clean, safe environment for patients. Ensures personal work space is neat, clean and free of debris at all times. Orders required supplies, including encounter forms, HIPAA booklets, Patient Rights and Responsibilities sheets, and office supplies.
Maintains and utilizes all office equipment such as computers, fax machines, telephones, etc. according to manufacturer’s recommendations.
Identifies need for maintenance of the department’s registration system, electronic equipment and business machines.
Reports computer malfunctions, software issues and/or problems to the Help Desk or appropriate staff.
Performs other duties and responsibilities that are appropriate to the position and area.The above responsibilities are a general description of the level and nature of the work assigned to this classification and are not to be considered as all inclusive.
About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation and research. Our 30,000 associates and 5,400 affiliated physicians work in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest visiting nurse association in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar is dedicated not only to teaching the next generation of doctors, but also to the continuing education and professional development of our whole team. MedStar Health offers diverse opportunities for career advancement and personal fulfillment.
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