HIM/PATIENT ACCESS REP (Part Time) - Part-time

div h4Job Details/h4 divstrongJob Location/strong: nbsp;nbsp;nbsp;Chester, CA/div divstrongEducation Level/strong: nbsp;nbsp;nbsp;None/div divstrongSalary Range/strong: nbsp;nbsp;nbsp;$18.63 - $24.52 Hourly/div divstrongJob Shift/strong: nbsp;nbsp;nbsp;Any/div /div h4Description/h4pstrongspan style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"Job Summarynbsp;nbsp; /span/span/strong/p pspan style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"This position is responsible for Patient Access duties including, but not limited to appointment scheduling, pre-registration, registration, insurance verification, prior-authorization, telephone coverage, explains and obtains signatures on forms, up-front collections, registration follow-up, and customer service. nbsp;nbsp;In addition, this position is responsible for maintaining, preserving, and releasing confidential health records in accordance with specified state agency, federal requirements, and hospital policies and is accountable for performing clerical and administrative functions to support the main HIM Department and billing services for both the Clinic and Hospital./span/span/p pstrongspan style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"Essential Functions ndash; Level 1/span/span/strong/p p style="margin-left:1px"span style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"strongReaches Proficiency in/strong:/span/span/p ul li pspan style="font-family:Arial,Helvetica,sans-serif"Registers patients by verifying identity and interviewing patients or representatives in a pleasant, professional, and timely manner according to department practices./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Validates existing data related to prior registrations by asking patient to repeat all data and update appropriately in the EHR./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Ensures all necessary demographic, guarantor, financial data, and emergency contacts are obtained and accurately entered into the Electronic Health Record (EHR).nbsp; /span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Enrolls the patient to the patient portal.nbsp; Validates the email address./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Selects the correct patient type and medical services./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Scans all necessary insurance information, including insurance cards, personal identification, driverrsquo;s license, physician order, etc. into EHR./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Identifies appropriate payor sources and verifies eligibility by thoroughly reading the report generated in the EHR or online.nbsp; Contacts health plan via telephone when electronic means of determination are not available./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Notifies health plans when patients transition to Observation, Inpatient, or Swing when necessary./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Completes timely Emergency Care Reporting to health plans requiring notification. /span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Reviews and understands the insurance eligibility reports to determine patientsrsquo; upfront costs./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Refers all private pay, underinsured patients, and Hospital Presumptive Eligibility applications to the Financial Counselor./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Answers and appropriately routes all incoming telephone calls./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Performs cashier functions for all patients who present cash, check or credit card as payment for services./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Maintain accurate records of cash, check, and credit card payments./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Understands and follows all regulatory requirements including but not limited to: Emergency Medical Treatment and Labor Act (EMTALA), Health Insurance Portability and Accountability (HIPAA), and Red Flag Rules./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Performs alternate provider workflow for non-staff providers including: NPI check and OIG Exclusion List checks. Documents all information in EHR./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Informs patients of and obtains signatures timely for all registration forms including but not limited to: Conditions of Admission, Patient Rights and Responsibilities, Notice of Privacy Practices, Acknowledgment of Patient Information on Advance Directives, Notice of Patient Visitation Policy, Patient Registration Form, Important Message from Medicare, and Medicare Observation Notice./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Possesses knowledge of and can explain all forms, required registration information, and procedures as needed./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Creates armbands, labels, and other documentation as necessary. Places armbands on patients following appropriate policy and procedure./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Completes Medicare Secondary Payor Questionnaire and documents responses in EHR./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Explains to Medicare patients options printed on the Advance Beneficiary Notice (ABN) and assists the patient completing the form.nbsp; Scans and documents the ABN into the EHR./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Assists patients with filling out medical records release forms. Verifies patient identity and documents on forms. Sends all Release of Information (ROI) forms to Health Information Management (HIM)./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Promptly answers phone calls at workstation and directs to appropriate area as necessary. Acts as District Operator coverage outside of business hours or as needed./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Answer all incoming calls, provide pertinent information to the caller, or screen and transfer the call to the appropriate source if requested/span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Relay voicemails and other messages to the proper location within the organization, which may entail writing down the number of the person who called and providing it to the individual/span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Perform various word processing responsibilities, which can include proofreading documents before they are sent out or updating the companyrsquo;s phone directory./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Record voicemail message for the company phone system, including messages stating when the office will be closed for holidays./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Displays exceptional customer service with patients, visitors, and peers by addressing and treating all with respect and understanding./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Attends and engages in department meetings, projects, teams, trainings, and committees./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Utilizes interpreter service to communicate with patients when needed./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Completes all job functions with discretion ensuring patient privacy and confidentiality./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Responds to emergency calls and pages emergency announcements in accordance with emergency response policies./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Performs hospital front desk duties. Receives visitors, obtains names and nature of business, and provides information and direction./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Works shift and area as assigned on schedule. Is cross trained in different coverage areas of Patient Access and HIM when requested./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Enters safety, feedback, and disruptive event reports as needed./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Always utilizes critical thinking./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Actively looks for solutions and shares ideas for improvement with team./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Maintains proactive and positive communication with management team, peers, and patients at all times./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Exhibits professionalism in appearance, speech and conducts following department dress policy while on shift./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Works on special projects as assigned./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Demonstrates the Districtrsquo;s Values in performance and behavior./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Complies with the Districtrsquo;s policies and procedures./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Check for duplicate medical records numbers./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Assists with referrals and pre-authorization tasks. /span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Other duties may be assigned./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Performs chart reconciliation and prepares the documents for scanning./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Follow-up on any missing documents and reporting of missing documents to the department head and HIM Director./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Accurately scan and title medical records received from other facilities, as well as our own, to the designated patientrsquo;s encounter and document name in the Electronic Health Record (EHR)./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Maintains an accurate and efficient filing of the old paper charts and stores the scanned documents in the Chart Room in an orderly manner./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Have an excellent understanding of medical record processes./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Maintain the medical record storage area./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Is the key contact of the HIM department./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Has excellent telephone and customer service attributes./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Demonstrates knowledge and understanding of the rules of confidentiality, chart analysis, terminal digit filing, scanning into the Electronic Health Record (EHR), and all policies and procedures associated with the job duties in a Health Information Management Department./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Schedules patients for outpatient and walk-in services. Assists in scheduling patients at check out./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Documents all estimates, conversations, and collections in EMR./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Utilizes patient schedules to prepare for patient appointments when possible, including but not limited to missing registration items, patient estimates, forms, schedules, and notes./span/p /li /ul p style="margin-left:1px"span style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"strongEssential Functions ndash; Level 2/strong/span/span/p p style="margin-left:1px"span style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"strongProficiency in Level 1 functions plus:/strong/span/span/p ul li pspan style="font-family:Arial,Helvetica,sans-serif"Obtains prior authorization for outpatient services./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Checks to ensure authorization has been obtained prior to services being rendered. If authorization is not in place, reschedule the service. Creates an estimate and discusses intent to proceed with a Non-Authorized Service as needed. Scans all appropriate documentation into the EHR./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Insurance Verification- accurately deciphers eligibility reports and confirms coverage and for medical services provided./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Holds sufficient understanding of insurance protocols for orders, authorizations, referrals, co-payments, deductibles, allowed amounts, etc./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Maintains and updates knowledge regarding all types of insurance and health plan coverage, utilizing reference materials provided, when necessary./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Performs quality checks, reports, audits, note-taking, and other clerical tasks for department when requested./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Works EHR work queues, pools, and worklists during each shift. /span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Follows up on all items including pre-registration and pre-admission missing registration items, emergency room visit missing registration items, appointment missing registration items, admission missing registration items, discharged patient missing registration items, returned mail, and claim edits./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Acts as mentor and operational trainer to new team members in conjunction with the Registration Lead. Trains, validates, and competency checks new team members. Communicates progress of trainee to Lead and supervisor./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Release medical records per facility policies, California Privacy Laws, and HIPAA regulations./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Performs 5% audit of scanned documents and reports mis-scans or missing images to the department director prior to destruction of the hard copy of scanned charts./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Purge medical records per retention directives./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Perform routine maintenance on the switchboard system or contacts outside contractor to visit the office to fix the system when necessary./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Obtains workerrsquo;s compensation accident information when applicable. Calls patient employer to verify employment. Obtains all insurance information from employer timely. Contacts insurance company to gather claim information. Enter all information into EHR./span/p /li /ul p style="margin-left:1px"span style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"strongEssential Functions ndash; Level 3/strong/span/span/p p style="margin-left:1px"span style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"strongProficiency and 3 years of experience in Levels 1-2/strong/span/span/p ul li pspan style="font-family:Arial,Helvetica,sans-serif"Utilizes price estimation tool, when applicable, to provide the most accurate estimate to patients. /span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Initiates patient financial conversations with respect and privacy. Creates estimates for services and delivers to patients. Collects estimated amount due. /span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Assist physicians in record completion and analysis/span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Assist with referrals and obtaining prior authorization when assigned./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Follows up on all worklist, queues, and pools and provide status to management daily.nbsp; Reaches out to lead or director for guidance and education for items unable to process./span/p /li /ul p style="margin-left:1px"span style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"strongEssential Functions ndash; Level 4/strong/span/span/p pspan style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"strongProficiency and 4 years of experience in Levels 1-3/strong/span/span/p ul li pspan style="font-family:Arial,Helvetica,sans-serif"Performs Chart Analysis for all patient types/span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Physician Suspension/span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Works closely with coding to process the DNFB with coding to determine missing documentation and reaches out to the provider to complete visits./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Compiles and processes Peer Review/span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Submits charts to Cancer Registry and is contact /span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Assists with Policies and Procedures management and training/span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Assists with HCAI State Submissions/span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Investigates complex insurance denials and edits; then brings resolution to management./span/p /li /ul pspan style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"uAt the discretion of the Department Manager, years of experience may be waived to be moved to the next level./u/span/span/p pnbsp;/p pspan style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"strongPhysical Requirements, Safety, and Environmental Conditionsnbsp;nbsp; /strong/span/span/p ul li pspan style="font-family:Arial,Helvetica,sans-serif"Follows safe work practices, takes an active interest in preventing injury or illness and promoting a safe and healthful environment for self and others, and complies with Hospital and governmental safety regulations./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Must function independently, have personal integrity, have flexibility and the ability to work effectively with other personnel, clients, and support agencies/span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Sits, stands, bends, lifts, walks, and moves intermittently during working hours and ability to lift up to 20 lbs./span/p /li /ul pspan style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"strongCompliance/strong/span/span/p ul li pspan style="font-family:Arial,Helvetica,sans-serif"Assumes personal responsibility to comply with all Federal, State and local laws governing business conduct, conducts business in an ethical and trustworthy manner, and displays the qualities and characteristics of a professional at all times when dealing with patients, visitors, physicians, volunteers, and fellow employees./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Exemplifies the Seneca Core Values in all aspects of work responsibilities and demonstrates these values to fellow employees and supervisors./span/p /li /ul p style="margin-left:1px"span style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"strongQuality of Work/strong/span/span/p ul li pspan style="font-family:Arial,Helvetica,sans-serif"Assumes responsibility for professional customer service when working with the public, physicians, and other departments.nbsp; /span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Strives for excellence in following policies and procedures. /span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Utilizes positive communication skills when interacting with people who work for, are serviced by, or associated with the hospital, to ensure that persons receive the highest degree of attention and courtesy./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Maintains confidentiality of information received in the department and throughout the hospital by complying with strict confidentiality regulations per HIPAA requirements./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Promotes professional growth of self and co-workers by participating in on-the-job training, continuing education and assisting with training of new employees./span/p /li /ul p style="margin-left:1px"span style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"strongWhy Seneca Healthcare District?/strong/span/span/p p style="margin-left:1px"span style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"Seneca employees are united in our quest to improve the health and well-being of our patients, and we empower each of our team members to fulfill this mission and reach their full potential regardless of job title or experience level./span/span/p p style="margin-left:1px"span style="font-family:Arial,Helvetica,sans-serif"span style="color:#000000"To this end, we offer:/span/span/p ul li pspan style="font-family:Arial,Helvetica,sans-serif"Leading benefits package for full-time and part-time employees, inclusive of health, prescription drug, dental, vision and life insurance coverage./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Sponsored 403(b) plan, with up to 3% matching contribution, and eligibility to participate in the District-funded pension program following one year of service./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"Accrued Paid Time Off (PTO) and Extended Sick Leave (ESL)./span/p /li li pspan style="font-family:Arial,Helvetica,sans-serif"A quot;One Teamquot; culture of deep respect and admiration across all teams and functions, regardless of role or background./span/p /li /ul h4Qualifications/h4brul li pspan style="font-size:12px;"span style="font-family:Arial, Helvetica, sans-serif;"One-year minimum of general clerical experience preferred./span/span/p /li li pspan style="font-size:12px;"span style="font-family:Arial, Helvetica, sans-serif;"Proficient typing speed at minimum of 35 words per minute with accuracy./span/span/p /li li pspan style="font-size:12px;"span style="font-family:Arial, Helvetica, sans-serif;"Knowledge of medical terminology and anatomy and physiology is desirable but not required./span/span/p /li li pspan style="font-size:12px;"span style="font-family:Arial, Helvetica, sans-serif;"Must possess the ability to communicate effectively both orally and in writing, to include legible handwriting, correct grammar, and spelling./span/span/p /li li pspan style="font-size:12px;"span style="font-family:Arial, Helvetica, sans-serif;"Must possess good working command of the English language./span/span/p /li li pspan style="font-size:12px;"span style="font-family:Arial, Helvetica, sans-serif;"Must possess the ability to operate standard office equipment and be computer literate./span/span/p /li li pspan style="font-size:12px;"span style="font-family:Arial, Helvetica, sans-serif;"Previous cash collections and financial institution experience desirable but not required./span/span/p /li /ul